Provider Demographics
NPI:1699030114
Name:UMYLNY, PAULINE L (PHD)
Entity Type:Individual
Prefix:DR
First Name:PAULINE
Middle Name:L
Last Name:UMYLNY
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 1:640 W 231ST ST
Mailing Address - Street 2:APT 7G
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-3256
Mailing Address - Country:US
Mailing Address - Phone:718-483-0781
Mailing Address - Fax:
Practice Address - Street 1:640 W 231ST ST
Practice Address - Street 2:APT 7G
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-3256
Practice Address - Country:US
Practice Address - Phone:718-483-0781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY68 018560103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist