Individual
DR. SUSAN GINSBERG PETAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
124 CHURCHILL RD, TENAFLY, NJ 07670-3120
(646) 418-4592
Mailing address
124 CHURCHILL RD, TENAFLY, NJ 07670-3120
(646) 418-4592
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
68 021572
NY
Other
Enumeration date
04/05/2016
Last updated
04/05/2016
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