Organization
KENNETH WINARICK PH.D.P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH BARD WINARICK PH.D. (PRESIDENT)
(917) 369-1721
Entity
Organization
Contact information
Practice address
125 E 74TH ST, NEW YORK, NY 10021-3217
(917) 369-1721
Mailing address
125 E 74TH ST, NEW YORK, NY 10021-3217
(917) 369-1721
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
005195
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
VS0471
MEDICARE
NY
Enumeration date
07/16/2014
Last updated
07/16/2014
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