Island Psychiatry, P.C.
Psychologist, Clinical in Port Jefferson Station, NY. Organization (NPI-2).
NPI number1609249754
StatusActive
Last updated in NPPESSep 27, 2026
Details
- NPI
- 1609249754
- Entity type
- Organization (NPI-2)
- Legal business name
- Island Psychiatry, P.C.
- Organization subpart
- No
- Enumeration date
- Nov 10, 2015
- Certification date
- Sep 27, 2026
- Last updated
- Sep 27, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | – | – | Yes |
Practice location
55 Nesconset HwyPort Jefferson Station, NY 11776-2631
Phone 631-474-8099
Mailing address
55 Nesconset HwyPort Jefferson Station, NY 11776-2631
Phone 631-474-8099
Authorized official
Randall Solomon
Owner
6314748099
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