Provider Demographics
NPI:1366516783
Name:SELECT PHYSICIANS
Entity type:Organization
Organization Name:SELECT PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BERNICE
Authorized Official - Middle Name:MEDNICK
Authorized Official - Last Name:REINHARTH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:516-488-9700
Mailing Address - Street 1:410 LAKEVILLE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1101
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:516-488-8826
Practice Address - Street 1:410 LAKEVILLE RD
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1101
Practice Address - Country:US
Practice Address - Phone:516-488-9700
Practice Address - Fax:516-488-8826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014647103TB0200X, 103TC0700X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY014647OtherPRACTITIONER LICENSE
NY014647OtherPRACTITIONER LICENSE