Organization
ETHAN A GRAHAM PHD PSYCHOLOGIST PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ETHAN A GRAHAM PH.D. (PSYCHOLOGIST)
(718) 702-2437
Entity
Organization
Contact information
Practice address
330 WEST 58TH STREET, SUITE 405, NEW YORK, NY 10019-1820
(718) 702-2437
Mailing address
330 WEST 58TH STREET, SUITE 405, NEW YORK, NY 10019-1820
(718) 702-2437
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
018415
NY
Other
Enumeration date
11/10/2011
Last updated
11/10/2011
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