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General NPI Number Information
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NPI Number | 1093066797
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Entity Type | Organization
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Legal Business Name | AVIVA ROHDE PHD PSYCHOLOGIST PC
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Dates
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Enumeration Date | 09/21/2012
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Last Update Date | 09/21/2012
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Provider Practice Location Address
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Address Line | 215 W 88TH ST 1C
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City | NEW YORK
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State | NY
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Zip | 10024-2321
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Country | US
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Telephone | 212-799-5119
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Fax | 212-799-5171
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Provider Business Mailing Address
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Address Line | 215 W 88TH ST 1C
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City | NEW YORK
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State | NY
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Zip | 10024-2321
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Country | US
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Telephone | 212-799-5119
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Fax | 212-799-5171
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AVIVA BETH ROHDE
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Credential | PHD
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Telephone | 212-799-5119
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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 | 011613
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License Number State | NY
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