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Organization
NEW YORK BEHAVIORAL HEALTH
Active
Organization
NEW YORK BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. J. RYAN FULLER PH.D. (CLINICAL DIRECTOR)
(646) 495-3078
Entity
Organization
Contact information
Practice address
909 3RD AVE, SUITE 505, NEW YORK, NY 10022-4731
(646) 495-3078
Mailing address
909 3RD AVE, NEW YORK, NY 10022-4731
(646) 495-3078
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
017620
NY
Other
Enumeration date
08/21/2009
Last updated
08/21/2009
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