Provider Demographics
NPI:1124468327
Name:KNISPEL, DENISE ALEXANDRA (PSYD)
Entity type:Individual
Prefix:DR
First Name:DENISE
Middle Name:ALEXANDRA
Last Name:KNISPEL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 FERNDALE AVE
Mailing Address - Street 2:
Mailing Address - City:SELDEN
Mailing Address - State:NY
Mailing Address - Zip Code:11784-3008
Mailing Address - Country:US
Mailing Address - Phone:631-219-2074
Mailing Address - Fax:
Practice Address - Street 1:99 LEXINGTON RD
Practice Address - Street 2:
Practice Address - City:SHIRLEY
Practice Address - State:NY
Practice Address - Zip Code:11967-2821
Practice Address - Country:US
Practice Address - Phone:631-281-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-02
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP89242103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist