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General NPI Number Information
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NPI Number | 1346500980
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Entity Type | Organization
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Legal Business Name | ADVANCED PSYCHOLOGICAL CARE PC
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Dates
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Enumeration Date | 05/16/2012
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Last Update Date | 06/22/2012
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Provider Practice Location Address
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Address Line | 62 WHITMAN DR
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City | BROOKLYN
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State | NY
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Zip | 11234-6703
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Country | US
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Telephone | 718-209-6561
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Fax |
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Provider Business Mailing Address
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Address Line | 62 WHITMAN DR
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City | BROOKLYN
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State | NY
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Zip | 11234-6703
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Country | US
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Telephone | 718-209-6561
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BELLA DORMAN
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Credential | PSY.D.
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Telephone | 917-704-8148
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 016309
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License Number State | NY
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