Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 008218-1 | NY |
Y | 103TC0700X | Clinical Psychologist | 008218-1 | NY |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 008218-1 | NY |
NPI | 1083755581 |
---|---|
Provider Name | Dr. Susan B Kraemer |
First Address | New York, NY 10025-3535 |
Second Address | New York, NY 10025-3535 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2007 |
Last Update Date | 19/06/2009 |