Provider Demographics
NPI:1154634509
Name:SHEFET, OREN MICHAEL (PHD)
Entity Type:Individual
Prefix:DR
First Name:OREN
Middle Name:MICHAEL
Last Name:SHEFET
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 1:130 POST AVE APT 401
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-3287
Mailing Address - Country:US
Mailing Address - Phone:917-355-7778
Mailing Address - Fax:
Practice Address - Street 1:21 REDWOOD LN
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-2718
Practice Address - Country:US
Practice Address - Phone:917-446-4532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-14
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017862103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical