| Organization Name: | ROBERT B. DEVINNEY, PH.D. PSYCHOLOGIST PC |
| NPI Number: | 1114049871 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBERT B. DEVINNEY (PRESIDENT) |
| Mailing Address: | 105 Medford Ave Patchogue |
| State: | NY US |
| Postal Code: | 117721223 |
| Phone Number: | 6319873780 |
| Fax Number: | 6312040069 |
| NPI Enumeration Date: | 04/04/2007 |
| NPI Last Update Date: | 04/27/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TA0400X |
| License Number: | 012661 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |