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General NPI Number Information
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NPI Number | 1114738911
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Entity Type | Organization
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Legal Business Name | GREENWICH PSYCHOLOGY PLLC
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Dates
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Enumeration Date | 01/20/2025
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Last Update Date | 01/20/2025
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Provider Practice Location Address
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Address Line | 445 PARK AVE
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City | NEW YORK
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State | NY
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Zip | 10022-2606
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Country | US
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Telephone | 203-900-1666
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Fax |
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Provider Business Mailing Address
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Address Line | 15 VALLEY DR STE 1
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City | GREENWICH
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State | CT
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Zip | 06831-5205
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Country | US
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Telephone | 203-900-1666
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR & FOUNDER
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Name | DR. JUDITH ZACKSON
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Credential | PH.D.
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Telephone | 203-900-1666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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