Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 018252 | NY |
Y | 103TC0700X | Clinical Psychologist | 018252 | NY |
N | 103TS0200X | School Psychologist | 818208 | NY |
NPI | 1063739811 |
---|---|
Provider Name | Dr. Eileen Marie Feliciano |
First Address | Brooklyn, NY 11209-3309 |
Second Address | Brooklyn, NY 11209-3309 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2010 |
Last Update Date | 06/12/2010 |