Healthcare Provider Details

I. General information

NPI: 1861986424
Provider Name (Legal Business Name): DAVID PARKER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2018
Last Update Date: 06/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 5TH AVE STE 920
NEW YORK NY
10003-3019
US

IV. Provider business mailing address

85 5TH AVE STE 920
NEW YORK NY
10003-3019
US

V. Phone/Fax

Practice location:
  • Phone: 646-675-1929
  • Fax:
Mailing address:
  • Phone: 646-675-1929
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number015798
License Number StateNY

VIII. Authorized Official

Name: DR. DAVID ANDREW PARKER
Title or Position: PSYCHOLOGIST
Credential: PSY.D.
Phone: 646-675-1929