Individual
LARISSA PORTNOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5 UNION SQ W # 1478, NEW YORK, NY 10003-3306
(347) 470-7760
Mailing address
5 UNION SQ W # 1478, NEW YORK, NY 10003-3306
(347) 470-7760
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
110582-01
NY
Other
Enumeration date
08/23/2021
Last updated
07/08/2026
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