Healthcare Provider Details

I. General information

NPI: 1346376969
Provider Name (Legal Business Name): KATHARINE R LAWSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1165 MORRIS PARK AVE FISHER LANDAU CENTER, CERC
BRONX NY
10461-1915
US

IV. Provider business mailing address

151 CHARLES ST
NEW YORK NY
10014-2539
US

V. Phone/Fax

Practice location:
  • Phone: 718-430-3900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number007022-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: