Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Michael L Nissnbaum, Ph D , Psychologist, PC

Organization Psychologist · NPI 1205009511

Michael L Nissnbaum, Ph D , Psychologist, PC is a Psychologist in Stony Brook, New York. Licensed in New York. Registered with an NPI since 2008.

Licensed in
NY
In the registry since
2008
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4 Coed Ln
Stony Brook, NY 11790-2704
Phone: (631) 737-9500
Fax: (631) 737-9512
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X · Licence 010232 (NY)

Record details

NPI number1205009511
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Nissenbaum — President · (631) 737-9500
NPI enumeratedApril 8, 2008
Last updated in NPPESJuly 1, 2008
Mailing address4 Coed Ln, Stony Brook, NY 11790-2704

Other providers in Stony Brook