Individual
PETRA TELAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
55 W 74TH ST APT 4A, NEW YORK, NY 10023-2441
(917) 325-4974
Mailing address
55 W 74TH ST APT 4A, NEW YORK, NY 10023-2441
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
02/26/2020
Last updated
02/26/2020
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