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General NPI Number Information
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NPI Number | 1225902950
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Entity Type | Organization
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Legal Business Name | JUNGIAN PSYCHOANALYTIC ASSOCIATION
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Dates
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Enumeration Date | 10/04/2025
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Last Update Date | 10/04/2025
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Provider Practice Location Address
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Address Line | 139 FULTON ST RM 612
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City | NEW YORK
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State | NY
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Zip | 10038-2534
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Country | US
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Telephone | 800-281-0630
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Fax |
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Provider Business Mailing Address
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Address Line | 105 E 34TH ST
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City | NEW YORK
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State | NY
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Zip | 10016-4601
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Country | US
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Telephone | 800-281-0630
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Fax |
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Authorized Official
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Title or Position | CLINICAL COORDINATOR
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Name | DONALD M GRASING
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Credential | LCSW
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Telephone | 917-647-7168
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 102L00000X
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Taxonomy Name | Psychoanalyst
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License Number |
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License Number State |
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