Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 000987-1 | NY |
N | 103T00000X | Psychologist | 000987-1 | NY |
Y | 102L00000X | Psychologist | 987-1 | NY |
Y | 103T00000X | Psychologist | 987-1 | NY |
NPI | 1003933813 |
---|---|
Provider Name | Dr. James Bruce Pearl |
First Address | New York, NY 10016 |
Second Address | New York, NY 10016 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2007 |
Last Update Date | 21/06/2017 |