Healthcare Provider Details

I. General information

NPI: 1447413810
Provider Name (Legal Business Name): TUBA TOKGOZ PH.D., LP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2008
Last Update Date: 06/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1651 3RD AVE SUITE 201
NEW YORK NY
10128-3679
US

IV. Provider business mailing address

1651 3RD AVE SUITE 201
NEW YORK NY
10128-3679
US

V. Phone/Fax

Practice location:
  • Phone: 646-639-8533
  • Fax:
Mailing address:
  • Phone: 646-639-8533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code103TP0814X
TaxonomyPsychoanalysis Psychologist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License Number000870
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: