Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 024561 | NY |
Y | 103TC0700X | Clinical Psychologist | 024561 | NY |
NPI | 1003579814 |
---|---|
Provider Name | Gabriella Podolski |
First Address | Teaneck, NJ 07666-2928 |
Second Address | New York, NY 10016-1919 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2021 |
Last Update Date | 19/10/2021 |