Provider Demographics
NPI:1245407519
Name:MORGANSTERN, MICHELE A (PHD)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:A
Last Name:MORGANSTERN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:994 W JERICHO TPKE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-3235
Mailing Address - Country:US
Mailing Address - Phone:631-786-8129
Mailing Address - Fax:
Practice Address - Street 1:994 W JERICHO TPKE
Practice Address - Street 2:SUITE 202
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-3235
Practice Address - Country:US
Practice Address - Phone:631-786-8129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017615103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical