Individual
DR. JESSICA LEE NUSBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
7403 COMMONWEALTH BLVD BLDG 55, BELLEROSE, NY 11426-1839
(718) 264-4574
Mailing address
7403 COMMONWEALTH BLVD BLDG 57, BELLEROSE, NY 11426-1839
(718) 264-4574
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
022689
NY
103TC0700X
Clinical Psychologist
Primary
022689
NY
Other
Enumeration date
09/21/2021
Last updated
11/18/2021
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