Provider Demographics
NPI:1124041678
Name:KIRBY, WILLIAM ANTHONY (PHD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ANTHONY
Last Name:KIRBY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 WARTON PL
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-3050
Mailing Address - Country:US
Mailing Address - Phone:516-742-6530
Mailing Address - Fax:516-747-3647
Practice Address - Street 1:7 WARTON PL
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-3050
Practice Address - Country:US
Practice Address - Phone:516-742-6530
Practice Address - Fax:516-747-3647
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010204103T00000X
NJSI02715103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist