Provider Demographics
NPI:1013345669
Name:WINICK, GEORGENE REICHER
Entity Type:Individual
Prefix:MRS
First Name:GEORGENE
Middle Name:REICHER
Last Name:WINICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 YALE AVE
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-2039
Mailing Address - Country:US
Mailing Address - Phone:516-569-3832
Mailing Address - Fax:516-569-7824
Practice Address - Street 1:321 WOODMERE BLVD
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-2035
Practice Address - Country:US
Practice Address - Phone:516-295-1340
Practice Address - Fax:516-295-1180
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-17
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool