Individual
DR. BRADLEY DALE ATLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH. D.
Contact information
Practice address
31 MERRICK AVE, SUITE 110, MERRICK, NY 11566-3477
(516) 375-0784
Mailing address
2554 SOUTHARD AVE, OCEANSIDE, NY 11572-1527
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
012070-1
NY
Other
Enumeration date
09/24/2006
Last updated
07/08/2007
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