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General NPI Number Information
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NPI Number | 1952559932
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Entity Type | Individual
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Provider Name | KYRA GROSMAN PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 09/03/2008
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Last Update Date | 02/23/2015
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Provider Practice Location Address
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Address Line | 26 W 9TH ST SUITE 4C
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City | NEW YORK
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State | NY
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Zip | 10011-8971
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Country | US
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Telephone | 510-692-2395
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Fax |
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Provider Business Mailing Address
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Address Line | 16 E 8TH ST APT. 3F
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City | NEW YORK
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State | NY
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Zip | 10003-5906
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Country | US
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Telephone | 510-692-2395
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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 | 4069
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 019508
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License Number State | NY
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