Individual
DR. SHELLEY JURAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
163 CLINTON ST, BROOKLYN, NY 11201-4601
(718) 625-6526
(718) 596-0518
Mailing address
101 CLARK ST, #19B, BROOKLYN, NY 11201-2746
(718) 625-6526
(718) 596-0518
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6331
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010987
GHI PROVIDER NUMBER
NY
01
—
135819
VALUE OPTIONS PROVIDER #
NY
Enumeration date
11/01/2006
Last updated
07/08/2007
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