Provider Demographics
NPI:1710232673
Name:GILHOOLEY, DAN (PSYAD)
Entity Type:Individual
Prefix:DR
First Name:DAN
Middle Name:
Last Name:GILHOOLEY
Suffix:
Gender:M
Credentials:PSYAD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 N HOWELLS POINT RD
Mailing Address - Street 2:
Mailing Address - City:BELLPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11713-2311
Mailing Address - Country:US
Mailing Address - Phone:631-286-0261
Mailing Address - Fax:
Practice Address - Street 1:25 EAST 10TH STREET
Practice Address - Street 2:SUITE 1F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:917-617-2415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-17
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000409-1102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst