Petersen, Leland W

Petersen, Leland W is an sole proprietor health care provider with primary practice located at 11 Beechwood Dr , Glen Head NY 11545-1101. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Petersen, Leland W can be contacted via phone (516) 671-7509.

Contact Information

Primary practice address
11 Beechwood Dr Glen Head NY 11545-1101
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 05430 New York

Profile Details

NPI number 1790902229
LBN Legal business name Petersen, Leland W
Credentials Certified Psychologist (CP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 19th, 2007
Last updated Oct 31st, 2007 - about 17 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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