Leland W. Petersen, Psychologist, P.c.

NPI #1083831408 in Glen Head, New York

Provider Information

NPI Number: 1083831408
Entity Type: Organization
Organization Name: Leland W. Petersen, Psychologist, P.c.
Primary Specialty: Psychologist - Clinical
Enumeration Date: Apr 19, 2007
Last Updated: Jun 17, 2008

Practice Location

Address: 11 BEECHWOOD DR
City: Glen Head
State: New York
ZIP Code: 11545-1101
Phone: (516) 671-7509

Authorized Official

Name: DR. LELAND WALTER PETERSEN, PH.D.
Title: PRESIDENT
Phone: (516) 671-7509

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Clinical — Clinical	103TC0700X	Primary

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