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Individual

DR. ELLIOT L JURIST

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D., PH.D.

Contact information

Practice address
96 5TH AVE, SUITE 1C, NEW YORK, NY 10011-7605
(646) 373-2688
Mailing address
96 5TH AVE, SUITE 1C, NEW YORK, NY 10011-7605
(646) 373-2688

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
013669
NY

Other

Enumeration date
09/24/2013
Last updated
09/24/2013
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