Individual
DR. JONATHAN MATHIAS LASSITER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1133 BROADWAY STE 510, NEW YORK, NY 10010-8173
(347) 498-3575
Mailing address
4312 WOODMONT CIR, SEWELL, NJ 08080-2285
(347) 498-3575
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
022738
NY
Other
Enumeration date
07/14/2010
Last updated
06/09/2021
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