Provider Demographics
NPI:1891152799
Name:LINDENBAUM, LOU (PHD)
Entity Type:Individual
Prefix:
First Name:LOU
Middle Name:
Last Name:LINDENBAUM
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 1:31 INTERNATIONAL BLVD
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:NY
Mailing Address - Zip Code:10509-2343
Mailing Address - Country:US
Mailing Address - Phone:845-278-7272
Mailing Address - Fax:845-278-6781
Practice Address - Street 1:31 INTERNATIONAL BLVD
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:NY
Practice Address - Zip Code:10509-2343
Practice Address - Country:US
Practice Address - Phone:845-278-7272
Practice Address - Fax:845-278-6781
Is Sole Proprietor?:No
Enumeration Date:2016-01-22
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001491-1103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities