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General NPI Number Information
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NPI Number | 1285151787
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Entity Type | Individual
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Provider Name | MICHAEL REDING PHD
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Gender | Male
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Dates
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Enumeration Date | 08/25/2017
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Last Update Date | 09/01/2022
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Provider Practice Location Address
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Address Line | 117 W 72ND ST STE 5E
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City | NEW YORK
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State | NY
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Zip | 10023-3204
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Country | US
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Telephone | 707-733-3381
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 293
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City | SPARROW BUSH
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State | NY
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Zip | 12780-0293
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Country | US
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Telephone | 707-733-3381
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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 | 004028
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License Number State | CT
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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 | 022302
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License Number State | NY
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