Dr. Nicole Petzolt
Psychologist Clinical Psychologist Adult Development & Aging Psychologist
3512 Quentin Rd Ste 110
Brooklyn
, New York 11234-4245
Dr. Nicole Petzolt
Psychologist Clinical Psychologist Adult Development & Aging Psychologist
3512 Quentin Rd Ste 110
Brooklyn
, New York 11234-4245
(718) 854-8370
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About
Features
Specialties
- Psychologist
- Adult Development & Aging Psychologist
- Clinical Psychologist
Languages spoken
- English
Location
First Address
- Dr. Nicole Petzolt
- 3512 Quentin Rd Ste 110
- Brooklyn, NY
- Zip : 11234-4245
- Phone : (718) 854-8370
Second Address
- Dr. Nicole Petzolt
- 3512 Quentin Rd Ste 110
- Brooklyn, NY
- Zip : 11234-4245
- Phone : (718) 854-8370
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 102L00000X | Psychologist | 020428-1 | NY |
| N | 103T00000X | Psychologist | 020428-1 | NY |
| N | 103TA0700X | Adult Development & Aging Psychologist | 020428-1 | NY |
| Y | 103G00000X | Clinical Psychologist | 020428-1 | NY |
| Y | 103TC0700X | Clinical Psychologist | 020428-1 | NY |
National Provider Identifier
| NPI | 1063836500 |
|---|---|
| Provider Name | Dr. Nicole Petzolt |
| First Address | Brooklyn, NY 11234-4245 |
| Second Address | Brooklyn, NY 11234-4245 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 04/02/2014 |
| Last Update Date | 13/05/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.