Basic Information
| Provider Information | |||||||||
| NPI: | 1780882308 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | APPENZELLER | ||||||||
| FirstName: | NATALIA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PH. D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 24 GARNETT PL | ||||||||
| Address2: | |||||||||
| City: | MELVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117474256 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6316924333 | ||||||||
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| Practice Location | |||||||||
| Address1: | 189 WHEATLEY ROAD | ||||||||
| Address2: | |||||||||
| City: | BROOKVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11747 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5166261000 | ||||||||
| FaxNumber: | 5166262039 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | 011719-1 | NY | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.