Individual
MR. GREGORY MUDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
1425 MADISON AVE, NEW YORK, NY 10029-6514
(917) 562-7569
Mailing address
1425 MADISON AVE, NEW YORK, NY 10029-6514
(917) 562-7569
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
72 072540
NY
Other
Enumeration date
12/13/2007
Last updated
12/13/2007
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