| Doctor Name: | DR. PAMELA B WASSERMAN |
| NPI Number: | 1043589575 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSYD |
| License Number: | 071005405 |
| Business Practice Address: | 115 Eileen Way Syosset, NY - 117915325 |
| Business Phone Number: | 5166959814 |
| Business Fax Number: | |
| Mailing Address: | 115 Eileen Way, SYOSSET |
| State: | NY |
| Postal Code: | 117915325 |
| Phone Number: | 5166959814 |
| Fax Number: | |
| NPI Enumeration Date: | 12/29/2011 |
| NPI Last Update Date: | 04/14/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 071005405 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |