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General NPI Number Information
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NPI Number | 1679796171
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Entity Type | Individual
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Provider Name | CHRISTINE ANZIEU-PREMMEREUR PHD
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Gender | Female
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 30 E 95TH ST APT 1B
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City | NEW YORK
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State | NY
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Zip | 10128-0721
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Country | US
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Telephone | 212-828-8422
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Fax | 212-996-7618
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Provider Business Mailing Address
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Address Line | 200 E 94TH ST APT 3012
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City | NEW YORK
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State | NY
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Zip | 10128-3915
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Country | US
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Telephone | 212-996-1109
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Fax | 212-996-7618
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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 | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 015496-1
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License Number State | NY
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