| Pediatric Psychology Of New York, Pllc | |
|
6083 71st St Maspeth NY 11378-2913 | |
| (888) 342-6002 | |
| (347) 344-6594 |
| Full Name | Pediatric Psychology Of New York, Pllc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 6083 71st St, Maspeth, New York |
| Authorized Official Name and Position | Mark Vincent Grudberg (MEMBER) |
| Authorized Official Contact | 8883426002 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Psychology Of New York, Pllc Po Box 604434 Bayside NY 11360-4434 Ph: (888) 342-6002 | Pediatric Psychology Of New York, Pllc 6083 71st St Maspeth NY 11378-2913 Ph: (888) 342-6002 |
| NPI Number | 1386910347 |
|---|---|
| Provider Enumeration Date | 03/23/2012 |
| Last Update Date | 03/23/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386910347 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 018098 (New York) | Primary |
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