Individual
DR. JAE LEE ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(212) 639-2000
Mailing address
633 3RD AVE, NEW YORK, NY 10017-6706
(646) 227-3764
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
025249
NY
103TC0700X
Clinical Psychologist
35SI00701400
NJ
103TC0700X
Clinical Psychologist
37386
TX
Other
Enumeration date
06/27/2011
Last updated
08/03/2023
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