Doctor Name: | MR. MARK ROBERT HONIG |
NPI Number: | 1477653376 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHD |
License Number: | NYSLIC6318 |
Business Practice Address: | 3630 Hill Boulevard Suite 204 Jefferson Valley, NY - 10535 |
Business Phone Number: | 9149626224 |
Business Fax Number: | 9142436899 |
Mailing Address: | 463 Bonnie Court, YORKTOWN HEIGHTS |
State: | NY |
Postal Code: | 10598 |
Phone Number: | 9142457527 |
Fax Number: | 9142436899 |
NPI Enumeration Date: | 09/22/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | NYSLIC6318 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |