Provider Demographics
NPI:1346556867
Name:ILENE JURMANN, PH.D., PSYCHOLOGIST, P.C.
Entity Type:Organization
Organization Name:ILENE JURMANN, PH.D., PSYCHOLOGIST, P.C.
Other - Org Name:COMPLETE PSYCHOLOGICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ILENE
Authorized Official - Middle Name:
Authorized Official - Last Name:JURMANN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:516-641-4961
Mailing Address - Street 1:51 ANN DR
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-5906
Mailing Address - Country:US
Mailing Address - Phone:516-641-4961
Mailing Address - Fax:
Practice Address - Street 1:5 DOWSING PL
Practice Address - Street 2:
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701-3719
Practice Address - Country:US
Practice Address - Phone:631-598-0147
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-21
Last Update Date:2010-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013920103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty