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General NPI Number Information
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NPI Number | 1114783636
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Entity Type | Organization
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Legal Business Name | KRISTEN ROMAN PSYCHOLOGY
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Dates
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Enumeration Date | 02/22/2024
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Last Update Date | 02/22/2024
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Provider Practice Location Address
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Address Line | 113 UNIVERSITY PL # 11F
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City | NEW YORK
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State | NY
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Zip | 10003-4527
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Country | US
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Telephone | 656-760-2778
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Fax |
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Provider Business Mailing Address
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Address Line | 300 E 71ST ST APT 18C
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City | NEW YORK
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State | NY
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Zip | 10021-5238
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Country | US
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Telephone | 646-760-2778
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KRISTEN ROMAN
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Credential | PSY.D.
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Telephone | 646-760-2778
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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