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General NPI Number Information
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NPI Number | 1124563879
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Entity Type | Organization
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Legal Business Name | PASCALE GOUSSELAND, PH.D
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Dates
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Enumeration Date | 01/04/2017
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Last Update Date | 01/04/2017
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Provider Practice Location Address
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Address Line | 117 E 71ST ST SUITE A
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City | NEW YORK
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State | NY
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Zip | 10021-4215
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Country | US
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Telephone | 212-472-6881
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Fax |
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Provider Business Mailing Address
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Address Line | 117 EAST 71ST ST SUITE A
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City | NEW YORK
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State | NY
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Zip | 10021-4383
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Country | US
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Telephone | 212-472-6881
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST/PSYCHOANALYST
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Name | DR. PASCALE C GOUSSELAND
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Credential | PH.D
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Telephone | 212-472-6881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | 000842
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License Number State | NY
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