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Individual

DR. MICHAEL J SMALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
49 FAWN WAY, LONG LAKE, NY 12847-0130
(518) 624-3346
(518) 624-5557
Mailing address
PO BOX 130, LONG LAKE, NY 12847-0130
(518) 624-3346
(518) 624-5557

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
013837
NY

Other

Enumeration date
05/22/2007
Last updated
07/08/2007
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