Individual
DR. DAMIAN MICHAEL GERLACH ELIAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1140 BROADWAY, STE 204, NEW YORK, NY 10001-7504
(215) 327-2504
Mailing address
582 5TH ST, APT #2B, BROOKLYN, NY 11215-3534
(215) 327-2504
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
019554
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019554
NYS LICENSE NUMBER
NY
Enumeration date
03/31/2011
Last updated
01/15/2013
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