Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 016671-1 | NY |
Y | 103TC0700X | Clinical Psychologist | 016671-1 | NY |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 016671-1 | NY |
NPI | 1073792503 |
---|---|
Provider Name | Natasha Crewdson-Gleizer |
First Address | Brooklyn, NY 11218-2579 |
Second Address | Brooklyn, NY 11218-2579 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2007 |
Last Update Date | 07/01/2022 |