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General NPI Number Information
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NPI Number | 1023656055
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Entity Type | Individual
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Provider Name | ANGIE AHMED MORSSAL PH.D.
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Gender | Female
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Dates
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Enumeration Date | 12/20/2019
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Last Update Date | 07/13/2020
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Provider Practice Location Address
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Address Line | 45 E 20TH ST FL 6
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City | NEW YORK
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State | NY
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Zip | 10003-1308
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Country | US
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Telephone | 917-473-8869
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Fax |
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Provider Business Mailing Address
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Address Line | 611 BROADWAY RM 718
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City | NEW YORK
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State | NY
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Zip | 10012-2649
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Country | US
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Telephone | 929-499-4577
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 103367-01
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License Number State | NY
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