Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 011510-1 | NY |
NPI | 1134443187 |
---|---|
Provider Name | Dr. Raizi Abby Janus |
First Address | Callicoon Center, NY 12724-0094 |
Second Address | Callicoon Center, NY 12724-0094 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2010 |
Last Update Date | 19/03/2010 |