Individual
BRYAN MULDOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
174 W 76TH ST, 6J, NEW YORK, NY 10023-8404
(212) 595-9623
Mailing address
174 W 76TH ST, 6J, NEW YORK, NY 10023-8404
(212) 595-9623
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
8631
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01758938
—
NY
Enumeration date
07/30/2006
Last updated
06/15/2015
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