Provider Demographics
NPI:1306905781
Name:CLINICAL NEUROPSYCHOLOGY SERVICES, PC
Entity type:Organization
Organization Name:CLINICAL NEUROPSYCHOLOGY SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUZAN
Authorized Official - Middle Name:
Authorized Official - Last Name:UYSAL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:914-238-1830
Mailing Address - Street 1:49 VALLEY VIEW RD
Mailing Address - Street 2:
Mailing Address - City:CHAPPAQUA
Mailing Address - State:NY
Mailing Address - Zip Code:10514-2523
Mailing Address - Country:US
Mailing Address - Phone:914-238-1830
Mailing Address - Fax:914-239-3557
Practice Address - Street 1:701 N BROADWAY
Practice Address - Street 2:PHELPS MEMORIAL HOSPITAL CENTER
Practice Address - City:SLEEPY HOLLOW
Practice Address - State:NY
Practice Address - Zip Code:10591-1020
Practice Address - Country:US
Practice Address - Phone:914-238-1830
Practice Address - Fax:914-239-3557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYVWW051Medicare ID - Type Unspecified