Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist | 015547 | NY |
NPI | 1659795417 |
---|---|
Provider Name | David Biderman |
First Address | New York, NY 10001-3006 |
Second Address | New York, NY 10001-3006 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2014 |
Last Update Date | 13/02/2014 |