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General NPI Number Information
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NPI Number | 1447456009
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Entity Type | Individual
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Provider Name | LUONNE ABRAM ROUSE D.MIN.
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Gender | Male
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Dates
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Enumeration Date | 06/21/2007
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Last Update Date | 11/03/2009
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Provider Practice Location Address
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Address Line | 1975 MADISON AVE
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City | NEW YORK
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State | NY
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Zip | 10035-1532
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Country | US
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Telephone | 212-289-6157
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Fax | 212-289-2368
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Provider Business Mailing Address
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Address Line | 1975 MADISON AVE
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City | NEW YORK
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State | NY
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Zip | 10035-1532
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Country | US
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Telephone | 212-289-6157
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Fax | 212-289-2368
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 000599-1
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License Number State | NY
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