Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 012962 | NY |
N | 103T00000X | Psychologist | 012962 | NY |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 012962 | NY |
N | 103G00000X | Clinical Psychologist | 012962 | NY |
N | 103TC0700X | Clinical Psychologist | 012962 | NY |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 012962 | NY |
N | 103TF0000X | Family Psychologist | 012962 | NY |
N | 103TS0200X | School Psychologist | 012962 | NY |
NPI | 1003962267 |
---|---|
Provider Name | Dr. Andrew Edward Vaughan |
First Address | Centerport, NY 11721-1109 |
Second Address | Huntington Station, NY 11746-3905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2007 |
Last Update Date | 08/07/2007 |