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General NPI Number Information
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NPI Number | 1912953175
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Entity Type | Individual
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Provider Name | ROBERT GANGI PH.D.
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Gender | Male
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 10/13/2016
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Provider Practice Location Address
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Address Line | 280 PARK AVE S SUITE 12H
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City | NEW YORK
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State | NY
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Zip | 10010-6121
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Country | US
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Telephone | 212-380-8059
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Fax | 718-238-1680
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Provider Business Mailing Address
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Address Line | 280 PARK AVE S APT 12H
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City | NEW YORK
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State | NY
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Zip | 10010-6130
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Country | US
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Telephone | 212-380-8059
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Fax | 212-212-3880
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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 | 016221-1
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License Number State | NY
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