Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 002827-1 | NY |
Y | 103TC0700X | Clinical Psychologist | 002827-1 | NY |
NPI | 1003076472 |
---|---|
Provider Name | Dr. Michael Beldoch |
First Address | New York, NY 10023-2675 |
Second Address | New York, NY 10023-2675 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2008 |
Last Update Date | 10/06/2008 |