Provider Demographics
NPI:1942791405
Name:HANNIGAN, TERENCE P (PHD)
Entity Type:Individual
Prefix:
First Name:TERENCE
Middle Name:P
Last Name:HANNIGAN
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 1:6 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-3216
Mailing Address - Country:US
Mailing Address - Phone:201-988-6009
Mailing Address - Fax:
Practice Address - Street 1:410 GIDNEY AVE
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-3763
Practice Address - Country:US
Practice Address - Phone:845-565-5072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-21
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY107270103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist