Provider Demographics
NPI:1922758556
Name:MCGLONE, TED JOSEPH III (LP, PHD)
Entity Type:Individual
Prefix:DR
First Name:TED
Middle Name:JOSEPH
Last Name:MCGLONE
Suffix:III
Gender:M
Credentials:LP, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-2139
Mailing Address - Country:US
Mailing Address - Phone:516-503-1271
Mailing Address - Fax:
Practice Address - Street 1:85 WALNUT ST
Practice Address - Street 2:
Practice Address - City:LYNBROOK
Practice Address - State:NY
Practice Address - Zip Code:11563-2139
Practice Address - Country:US
Practice Address - Phone:516-503-1271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-26
Last Update Date:2022-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001121102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst