Provider Demographics
NPI:1639269327
Name:NAGLER, KATHI LYNN (PHD)
Entity Type:Individual
Prefix:DR
First Name:KATHI
Middle Name:LYNN
Last Name:NAGLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MISS
Other - First Name:KATHI
Other - Middle Name:LYNN
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:31 MERRICK AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566
Mailing Address - Country:US
Mailing Address - Phone:516-379-4500
Mailing Address - Fax:516-766-5975
Practice Address - Street 1:31 MERRICK AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566
Practice Address - Country:US
Practice Address - Phone:516-379-4500
Practice Address - Fax:516-766-5975
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010128103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist