Individual
MS. IRIS E FODOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
175 W 12TH ST, APT 2-N, NEW YORK, NY 10011
(212) 604-9442
Mailing address
110 BLEECKER ST, APT 16A, NEW YORK, NY 10012
(212) 982-0177
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
004012
NY
Other
Enumeration date
05/22/2007
Last updated
07/08/2007
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