Doctor Name: | DR. M RONALD MINGE |
NPI Number: | 1275726531 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | 4073-1 |
Business Practice Address: | 10 Main St Suite 325 New Paltz, NY - 125611762 |
Business Phone Number: | 8452558396 |
Business Fax Number: | 8452551620 |
Mailing Address: | 4 Van Kleeck Ave, NEW PALTZ |
State: | NY |
Postal Code: | 125613129 |
Phone Number: | 8452558396 |
Fax Number: | 8452551620 |
NPI Enumeration Date: | 08/21/2007 |
NPI Last Update Date: | 08/21/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 4073-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |