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General NPI Number Information
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NPI Number | 1255702049
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Entity Type | Individual
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Provider Name | JOHN LITT
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Gender | Male
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Dates
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Enumeration Date | 10/19/2015
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Last Update Date | 10/19/2015
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Provider Practice Location Address
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Address Line | 595 GERARD AVE
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City | BRONX
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State | NY
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Zip | 10451-5239
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Country | US
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Telephone | 718-742-6067
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Fax |
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Provider Business Mailing Address
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Address Line | 278 N WASHINGTON ST APT 2
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City | SLEEPY HOLLOW
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State | NY
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Zip | 10591-2329
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Country | US
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Telephone | 718-742-6067
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 014814-1
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License Number State | NY
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