Individual
MIRIAM KRAGNESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
301 E 17TH ST, REHABILITATION PSYCHOLOGY, NEW YORK, NY 10003-3804
(212) 598-3883
(212) 598-6249
Mailing address
301 E 17TH ST, REHABILITATION PSYCHOLOGY, NEW YORK, NY 10003-3804
(212) 598-3883
(212) 598-6249
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
015596-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
113259
UCARE
MN
05
—
430057200
—
MN
01
—
522T5KR
BLUECROSSBLUESHIELD
MN
01
—
61-56492
MEDICA
MN
01
—
HP48976
HEALTHPARTNERS
MN
Enumeration date
11/15/2006
Last updated
10/16/2014
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