Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 011520 | NY |
NPI | 1144378266 |
---|---|
Provider Name | Dr. Sheila Connolly Ferentino |
First Address | Bayside, NY 11360-2155 |
Second Address | Bayside, NY 11360-2155 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2007 |
Last Update Date | 08/07/2007 |