Individual
DR. ELLIOT KAMINETZKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D
Contact information
Practice address
90 BROAD ST STE 323, NEW YORK, NY 10004-2205
(646) 580-4572
Mailing address
90 BROAD ST STE 323, NEW YORK, NY 10004-2205
(646) 580-4572
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
022872
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
83-2032785
IRS
NY
Enumeration date
10/17/2018
Last updated
09/11/2025
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