Individual
DR. MICHAEL DUNCAN FRASER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
234 E 149TH ST UNIT 4A, LINCOLN HOSPITAL, BRONX, NY 10451-5504
(718) 579-5476
Mailing address
178 E 70TH ST, APT 1FE, NEW YORK, NY 10021-5116
(918) 886-4063
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
015307
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015307
NEW YORK STATE LICENSE ID
NY
05
—
340810
—
NY
Enumeration date
12/13/2006
Last updated
07/09/2007
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