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Individual

AMY ALTHOFF MERBAUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LP

Contact information

Practice address
16 W 10TH ST, NEW YORK, NY 10011-8707
(917) 747-0078
Mailing address
6820 BURNS ST APT D4, FOREST HILLS, NY 11375-5080

Taxonomy

Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
Primary
PO5952
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
82-1155629
IRS
OH
Enumeration date
05/24/2017
Last updated
05/24/2017
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