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Clinical Neuropsychologist

New York, New York

Provider NPI: 1982712949

Provider Information:
Gender: F
Sole Proprietor

Practice Location:
Tel: 917-270-3019  Fax: 718-982-4114

Business Mailing Address:
330 E 46TH ST APT 10D  NEW YORK, NY 10017 US
Tel: 917-270-3019  Fax: 718-982-4114

Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
X103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
X103TC0700XBehavioral Health & Social Service Providers

Other Provider Identifiers:

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin


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