Doctor Name: | DR. CATHERINE MIRIAM WANKO-NEWMAN |
NPI Number: | 1124162441 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSY.D. |
License Number: | 012789 |
Business Practice Address: | 96 State Route 302 Pine Bush, NY - 125667102 |
Business Phone Number: | 8457443966 |
Business Fax Number: | 8457443966 |
Mailing Address: | 96 State Route 302, PINE BUSH |
State: | NY |
Postal Code: | 125667102 |
Phone Number: | 8457443966 |
Fax Number: | 8457443966 |
NPI Enumeration Date: | 02/19/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 012789 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |