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General NPI Number Information
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NPI Number | 1689890873
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Entity Type | Individual
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Provider Name | ELIZABETH MUNIZ PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 280 MADISON AVE SUITE #1110
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City | NEW YORK
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State | NY
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Zip | 10016
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Country | US
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Telephone | 646-526-4111
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Fax |
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Provider Business Mailing Address
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Address Line | 139-19 31ST RD
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City | FLUSHING
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State | NY
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Zip | 11354
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Country | US
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Telephone | 646-526-4111
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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 | 014168
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License Number State | NY
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