Individual
DR. CHARLES J. CORLISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
425 E 86TH ST, SUITE 1D, NEW YORK, NY 10028-6449
(212) 410-0499
(212) 567-9476
Mailing address
425 E 86TH ST, SUITE 1D, NEW YORK, NY 10028-6449
(212) 410-0499
(212) 567-9476
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
008791-1
NY
Other
Enumeration date
12/27/2006
Last updated
07/08/2007
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