Provider Demographics
NPI:1790823813
Name:OSWALD, MONICA (PHD)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:
Last Name:OSWALD
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 1:9 DELANO LN
Mailing Address - Street 2:
Mailing Address - City:KINGS PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11754-2814
Mailing Address - Country:US
Mailing Address - Phone:631-366-2628
Mailing Address - Fax:631-366-2628
Practice Address - Street 1:9 DELANO LN
Practice Address - Street 2:
Practice Address - City:KINGS PARK
Practice Address - State:NY
Practice Address - Zip Code:11754-2814
Practice Address - Country:US
Practice Address - Phone:631-366-2628
Practice Address - Fax:631-366-2628
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012776103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist