Healthcare Provider Details
I. General information
NPI: 1396763033
Provider Name (Legal Business Name): JANET NORMAN PSY.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
666 KAPPOCK ST
BRONX NY
10463-7704
US
IV. Provider business mailing address
1 OLD COUNTRY RD SUITE 271
CARLE PLACE NY
11514-1801
US
V. Phone/Fax
- Phone: 718-549-1203
- Fax: 718-884-3792
- Phone: 800-725-6280
- Fax: 800-725-6380
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | 016248 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: