Individual
DR. ERIC A. FERTUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
286 MADISON AVE, NEW YORK, NEW YORK, NY 10017-6345
(212) 213-5088
Mailing address
286 MADISON AVE, NEW YORK, NEW YORK, NY 10017-6345
(212) 213-5088
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
13946
NY
Other
Enumeration date
08/13/2010
Last updated
08/13/2010
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