Provider Demographics
NPI:1811177926
Name:CAROLE J SYMER PSYCHOLOGY PC
Entity type:Organization
Organization Name:CAROLE J SYMER PSYCHOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROLE
Authorized Official - Middle Name:J
Authorized Official - Last Name:SYMER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:631-324-8515
Mailing Address - Street 1:7 MUCHMORE LN
Mailing Address - Street 2:SUITE 1
Mailing Address - City:EAST HAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11937-7401
Mailing Address - Country:US
Mailing Address - Phone:631-324-8515
Mailing Address - Fax:631-324-8516
Practice Address - Street 1:7 MUCHMORE LN
Practice Address - Street 2:SUITE 1
Practice Address - City:EAST HAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11937-7401
Practice Address - Country:US
Practice Address - Phone:631-324-8515
Practice Address - Fax:631-324-8516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014148103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
V6W491Medicare PIN