1598925687 NPI number — CONNIE K MCNEIL, CLINICAL PSYCHOLOGIST PLLC

Table of content: (NPI 1598925687)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598925687 NPI number — CONNIE K MCNEIL, CLINICAL PSYCHOLOGIST PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CONNIE K MCNEIL, CLINICAL PSYCHOLOGIST PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598925687
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/29/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
455 CENTRAL PARK AVE
Provider Second Line Business Mailing Address:
SUITE 202
Provider Business Mailing Address City Name:
SCARSDALE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10583-1060
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-472-3711
Provider Business Mailing Address Fax Number:
914-723-7637

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
455 CENTRAL PARK AVE
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
SCARSDALE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10583-1060
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-472-3711
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/11/2008

Additional Information

Authorized Official

Authorized Official Last Name:
MCNEIL
Authorized Official First Name:
CONNIE
Authorized Official Middle Name:
K
Authorized Official Title or Position:
OWNER/PRESIDENT
Authorized Official Telephone Number:
914-472-3711

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  014435-3 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 353135 . This is a "MANAGED HEALTH NETWORK" identifier . This identifiers is of the category "OTHER".
  • Identifier: V636D2 . This is a "EMPIRE BC/BS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 248092502 . This is a "UNITED BEHAVORIAL HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9642616 . This is a "GHI" identifier . This identifiers is of the category "OTHER".
  • Identifier: P3152244 . This is a "OXFORD HEALTH PLANS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 719023000 . This is a "MAGELLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 680015163 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 02145577 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2143084 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: S14435-2W . This is a "WORKER'S COMPENSATION BOARD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 447585125 . This is a "POMCO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0007025351 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 014435 . This is a "HIP OF NEW YORK" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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