Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 015058 | NY |
NPI | 1174667349 |
---|---|
Provider Name | Dr. Micah Galen Duchan |
First Address | Brooklyn, NY 11234-4922 |
Second Address | Brooklyn, NY 11234-4922 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2007 |
Last Update Date | 08/07/2007 |