Provider Demographics
NPI:1972323269
Name:ALLICOCK, NEIL (PHD)
Entity type:Individual
Prefix:DR
First Name:NEIL
Middle Name:
Last Name:ALLICOCK
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:552 51ST AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-6279
Mailing Address - Country:US
Mailing Address - Phone:347-270-7696
Mailing Address - Fax:
Practice Address - Street 1:552 51ST AVE APT 2
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-6279
Practice Address - Country:US
Practice Address - Phone:347-270-7696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-12
Last Update Date:2024-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist