Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 022996-1 | NY |
NPI | 1083183487 |
---|---|
Provider Name | Dr. Elijah Bell |
First Address | Nanuet, NY 10954-0352 |
Second Address | Bronx, NY 10472-6431 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2018 |
Last Update Date | 15/11/2018 |