Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 019504 | NY |
NPI | 1164848800 |
---|---|
Provider Name | Frederick Muench |
First Address | Brooklyn, NY 11215-2103 |
Second Address | New York, NY 10032-3725 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2014 |
Last Update Date | 05/03/2014 |