Provider Demographics
NPI:1851468896
Name:KIFER, ROBERT E (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:E
Last Name:KIFER
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 1:122 MIDWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:NESCONSET
Mailing Address - State:NY
Mailing Address - Zip Code:11767-2004
Mailing Address - Country:US
Mailing Address - Phone:631-361-4761
Mailing Address - Fax:631-361-4761
Practice Address - Street 1:358 VETERANS MEMORIAL HWY STE 9
Practice Address - Street 2:INSTITUTE FOR BEHAVIORAL HEALTH
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-4326
Practice Address - Country:US
Practice Address - Phone:631-543-4357
Practice Address - Fax:631-543-2223
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY05666103TC2200X, 103TM1800X
NY103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Not Answered103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
Not Answered103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool