Individual
GABRIELLA NISSAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
184 E 70TH ST STE 5, NEW YORK, NY 10021-5154
(646) 580-5845
Mailing address
219 E 69TH ST APT 3M, NEW YORK, NY 10021-0022
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
025770
NY
103T00000X
Psychologist
35SI00724100
NJ
Other
Enumeration date
09/13/2021
Last updated
11/08/2024
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