Individual
DOUGLAS J VAN DER HEIDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7 E 85TH ST, NYC, NY 10028-0440
(212) 772-6443
Mailing address
10 E 85TH ST, 5A, NYC, NY 10028-0412
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
131230
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00509673
—
NY
Enumeration date
03/15/2006
Last updated
08/19/2015
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