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General NPI Number Information
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NPI Number | 1619493772
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Entity Type | Individual
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Provider Name | DEBORAH ANN KRISHNAN PSYD
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Gender | Female
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Dates
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Enumeration Date | 08/20/2017
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Last Update Date | 08/20/2017
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Provider Practice Location Address
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Address Line | 156 5TH AVE STE 1107
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City | NEW YORK
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State | NY
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Zip | 10010-7749
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Country | US
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Telephone | 609-731-2964
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Fax |
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Provider Business Mailing Address
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Address Line | 432 E 83RD ST APT 1D
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City | NEW YORK
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State | NY
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Zip | 10028-5513
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Country | US
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Telephone | 609-731-2964
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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 | 021625
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License Number State | NY
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