Individual
DR. ELISABETH R FONSECA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
276 5TH AVE, SUITE 1101, NEW YORK, NY 10001-4509
(212) 683-3339
Mailing address
276 5TH AVE, SUITE 1101, NEW YORK, NY 10001-4509
(212) 683-3339
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
013336-1
NY
103TC0700X
Clinical Psychologist
9868
MA
Other
Enumeration date
02/05/2015
Last updated
02/05/2015
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