DR. Kevin Joseph Nissen, PH.D.

NPI #1245093616 in Northport, New York

Provider Information

NPI Number: 1245093616
Entity Type: Individual
Name: DR. Kevin Joseph Nissen, PH.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Psychologist
Credential: PH.D.
Enumeration Date: Jan 30, 2024
Last Updated: Jan 30, 2024

Practice Location

Address: 79 MIDDLEVILLE RD
City: Northport
State: New York
ZIP Code: 11768-2200
Phone: (631) 261-4400

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist	103T00000X	Primary

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