Individual
DR. JORGE LUIS ALCANTAR-HEREDIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
245 E 19TH ST APT 18A, NEW YORK, NY 10003-2662
(805) 540-1555
Mailing address
245 E 19TH ST APT 18A, NEW YORK, NY 10003-2662
(805) 540-1555
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
024491
NY
Other
Enumeration date
07/13/2016
Last updated
11/05/2021
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