Provider Demographics
NPI:1689834558
Name:CONTE, VINCENT ANTHONY (PHD)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:ANTHONY
Last Name:CONTE
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 1:21337 39TH AVE
Mailing Address - Street 2:312
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-2071
Mailing Address - Country:US
Mailing Address - Phone:516-425-5456
Mailing Address - Fax:
Practice Address - Street 1:1728 BROADWAY STE 1
Practice Address - Street 2:
Practice Address - City:HEWLETT
Practice Address - State:NY
Practice Address - Zip Code:11557-1630
Practice Address - Country:US
Practice Address - Phone:516-596-0073
Practice Address - Fax:516-599-5698
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-13
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011940-1103T00000X, 103TA0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & AgingGroup - Single Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologist