Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 012292-1 | NY |
N | 103T00000X | Psychologist | 012292-1 | NY |
N | 103TA0700X | Adult Development & Aging Psychologist | 012292-1 | NY |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 012292-1 | NY |
Y | 103G00000X | Clinical Psychologist | 012292-1 | NY |
Y | 103TC0700X | Clinical Psychologist | 012292-1 | NY |
N | 103TH0100X | Health Service | 012291-1 | NY |
N | 103TP0814X | Psychoanalysis | 012292-1 | NY |
N | 103TP2701X | Group Psychotherapist | 012292-1 | NY |
N | 103TR0400X | Rehabilitation Psychologist | 012292-1 | NY |
NPI | 1063431625 |
---|---|
Provider Name | Dr. Herbert Gary Gingold |
First Address | Kew Gardens, NY 11415-2444 |
Second Address | Kew Gardens, NY 11415-2444 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 28/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01538756 | (05) | NY |