Individual
DR. MICHAEL PAUL DETRES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
500 W 43RD ST, 28C, NEW YORK, NY 10036-4327
(212) 268-3687
Mailing address
500 W 43RD ST, 28C, NEW YORK, NY 10036-4327
(212) 268-3687
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
012712
NY
Other
Enumeration date
12/23/2006
Last updated
07/08/2007
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