Pediatric Psychology of New York, Pllc

NPI #1386910347 in Maspeth, New York

Provider Information

NPI Number: 1386910347
Entity Type: Organization
Organization Name: Pediatric Psychology of New York, Pllc
Primary Specialty: Psychologist - Clinical
Enumeration Date: Mar 23, 2012
Last Updated: Mar 23, 2012

Practice Location

Address: 6083 71ST ST
City: Maspeth
State: New York
ZIP Code: 11378-2913
Phone: (888) 342-6002

Authorized Official

Name: DR. MARK VINCENT GRUDBERG, PH.D.
Title: MEMBER
Phone: (888) 342-6002

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Clinical — Clinical	103TC0700X	Primary

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