Individual
DR. BRIAN A PETERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
412 6TH AVE, #610, NEW YORK, NY 10011-8409
(917) 621-5822
(212) 346-1530
Mailing address
156 WILLIAM ST, 12TH FLOOR, NEW YORK, NY 10038-2609
(917) 621-5822
(212) 346-1530
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
# 016797-1
NY
Other
Enumeration date
08/14/2009
Last updated
08/14/2009
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