| Organization Name: | FERNDALE PSYCHOLOGICAL SERVICES |
| NPI Number: | 1164827317 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL E SCHWARTZ (OWNER) |
| Mailing Address: | 111 Sullivan Ave Suite 2-5 Ferndale |
| State: | NY US |
| Postal Code: | 127344315 |
| Phone Number: | 8452926222 |
| Fax Number: | 8452926220 |
| NPI Enumeration Date: | 10/30/2014 |
| NPI Last Update Date: | 10/30/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |