Provider Demographics
NPI:1689977704
Name:DYNDA, AGNIESZKA M (PSYD)
Entity Type:Individual
Prefix:DR
First Name:AGNIESZKA
Middle Name:M
Last Name:DYNDA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1A GRASSFIELD RD
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11024-1406
Mailing Address - Country:US
Mailing Address - Phone:516-441-4200
Mailing Address - Fax:
Practice Address - Street 1:105 CLOVER DR
Practice Address - Street 2:PUPIL PERSONNEL SERVICES-GREAT NECK PUBLIC SCHOOLS
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-1031
Practice Address - Country:US
Practice Address - Phone:516-441-4970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-10
Last Update Date:2020-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018530103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool