Provider Demographics
NPI:1205952132
Name:ARNOLD, DREW JEFFREY (PHD)
Entity type:Individual
Prefix:
First Name:DREW
Middle Name:JEFFREY
Last Name:ARNOLD
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 1:4406 SCOTT RD
Mailing Address - Street 2:
Mailing Address - City:BLUFF POINT
Mailing Address - State:NY
Mailing Address - Zip Code:14478-9717
Mailing Address - Country:US
Mailing Address - Phone:315-536-8639
Mailing Address - Fax:
Practice Address - Street 1:316 ELM ST
Practice Address - Street 2:
Practice Address - City:PENN YAN
Practice Address - State:NY
Practice Address - Zip Code:14527-1410
Practice Address - Country:US
Practice Address - Phone:315-536-6241
Practice Address - Fax:315-536-8773
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011271103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist