Individual
DR. ALBERT STEPHEN BANTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
150 W 82ND ST APT 1A, NEW YORK, NY 10024-7302
(917) 355-9231
Mailing address
150 W 82ND ST APT 1A, NEW YORK, NY 10024-7302
(917) 355-9231
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
017822-1
NY
Other
Enumeration date
01/02/2009
Last updated
01/02/2009
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