Provider Demographics
NPI:1588679666
Name:ACCOMANDO, BEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:BEN
Middle Name:
Last Name:ACCOMANDO
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 1:2563 EILEEN RD
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-1308
Mailing Address - Country:US
Mailing Address - Phone:516-599-2290
Mailing Address - Fax:516-599-2815
Practice Address - Street 1:2563 EILEEN RD
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-1308
Practice Address - Country:US
Practice Address - Phone:516-599-2290
Practice Address - Fax:516-599-2815
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6185103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV18461Medicare ID - Type Unspecified