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Individual

DAVID WELLEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
1745 BROADWAY, 17 FL, NEW YORK, NY 10019-4640
(212) 851-8100
(212) 537-0102
Mailing address
120 3RD ST UNIT A, SOUTH ORANGE, NJ 07079-1856
(646) 299-4332

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
13903
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01960278
NY
Enumeration date
08/01/2006
Last updated
06/15/2015
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