Organization
MAXINE L. GANN PSYCHOLOGIST, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAXINE L. GANN PH.D. (PRESIDENT)
(212) 860-3368
Entity
Organization
Contact information
Practice address
1199 PARK AVE, SUITE 1K, NEW YORK, NY 10128-1711
(212) 860-3368
(212) 202-3890
Mailing address
8 E 96TH ST, SUITE 5A, NEW YORK, NY 10128-0706
(212) 860-3368
(212) 202-3890
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
7966
NY
103TC0700X
Clinical Psychologist
7966
NY
103TP0814X
Psychoanalysis Psychologist
7966
NY
Other
Enumeration date
09/06/2013
Last updated
09/06/2013
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