Grodewald-Adler, Amanda Lea

Grodewald-Adler, Amanda Lea is an individual health care provider with primary practice located at 1919 Middle Country Rd Suite 308, Centereach NY 11720-5601. She recently has only one registered license in Behavioral Health & Social Service Providers / Cognitive & Behavioral, which is considered as her primary health care specialty. Grodewald-Adler, Amanda Lea can be contacted via phone (631) 209-5343.

Contact Information

Primary practice address
1919 Middle Country Rd Suite 308 Centereach NY 11720-5601
Phone: (631) 209-5343
Fax: (631) 648-7655
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Cognitive & Behavioral 103TB0200X P77977 New York

Profile Details

NPI number 1144520768
LBN Legal business name Grodewald-Adler, Amanda Lea
Credentials PSY.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 29th, 2010
Last updated Oct 21st, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144520768 NPPES
New York Other A300066521 MEDICARE PTAN

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