Healthcare Provider Details

I. General information

NPI: 1104603950
Provider Name (Legal Business Name): ZACHARY HUBERT PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2023
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 UNION SQ E STE 1100
NEW YORK NY
10003-3209
US

IV. Provider business mailing address

7 E 14TH ST APT 928
NEW YORK NY
10003-3126
US

V. Phone/Fax

Practice location:
  • Phone: 212-675-3205
  • Fax:
Mailing address:
  • Phone: 973-830-7091
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number027209
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: