Individual
DR. MICHAEL INDENBAUM RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
167 MADISON AVE SUITE 205 1004, NEW YORK, NY 10016
(929) 244-0018
Mailing address
167 MADISON AVE RM 205 #1004, NEW YORK, NY 10016-5403
(929) 244-0018
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
024679
NY
103TB0200X
Cognitive & Behavioral Psychologist
024679
NY
103TC0700X
Clinical Psychologist
Primary
024679
NY
103TP2701X
Group Psychotherapy Psychologist
024679
NY
Other
Enumeration date
05/01/2020
Last updated
06/21/2023
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