Provider Demographics
NPI:1639778723
Name:POSTAL, JAMIE MARIE (PHD)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:MARIE
Last Name:POSTAL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 N BROADWAY STE 215
Mailing Address - Street 2:
Mailing Address - City:JERICHO
Mailing Address - State:NY
Mailing Address - Zip Code:11753-2128
Mailing Address - Country:US
Mailing Address - Phone:516-304-0827
Mailing Address - Fax:
Practice Address - Street 1:500 N BROADWAY STE 215
Practice Address - Street 2:
Practice Address - City:JERICHO
Practice Address - State:NY
Practice Address - Zip Code:11753-2128
Practice Address - Country:US
Practice Address - Phone:516-719-6383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-20
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023971103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist