Individual
DR. MERIDITH LARA AMBROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
295 CENTRAL PARK W OFC 6, NEW YORK, NY 10024-3021
(973) 600-8866
Mailing address
28 W 3RD ST APT 1430, SOUTH ORANGE, NJ 07079-1787
(973) 600-8866
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
023769
NY
Other
Enumeration date
10/07/2021
Last updated
10/12/2021
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