Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0700X | Adult Development & Aging Psychologist | ||
N | 103TB0200X | Cognitive & Behavioral Psychologist | ||
Y | 103G00000X | Clinical Psychologist | 019727 | NY |
Y | 103TC0700X | Clinical Psychologist | 019727 | NY |
NPI | 1861740474 |
---|---|
Provider Name | Dr. Chaim Siegel |
First Address | Far Rockaway, NY 11691-5506 |
Second Address | Far Rockaway, NY 11691-5506 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2012 |
Last Update Date | 29/08/2012 |