Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 021697 | NY |
Y | 103TC0700X | Clinical Psychologist | 021697 | NY |
N | 103TA0700X | Adult Development & Aging Psychologist | 021697 | NY |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 021697 | NY |
N | 103G00000X | Clinical Psychologist | 021697 | NY |
N | 103TC0700X | Clinical Psychologist | 021697 | NY |
N | 103TR0400X | Rehabilitation Psychologist | 021697 | NY |
NPI | 1437502432 |
---|---|
Provider Name | Dr. Thomas E. Myers |
First Address | Plainview, NY 11803 |
Second Address | Melville, NY 11747-2290 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2016 |
Last Update Date | 23/01/2020 |