Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 020060-1 | NY |
NPI | 1073992582 |
---|---|
Provider Name | Dr. Elana Spira |
First Address | New York, NY 10016-5802 |
Second Address | New York, NY 10016-5802 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2015 |
Last Update Date | 29/05/2015 |