Doctor Name: | DR. CAROL RUTH BRAVMANN |
NPI Number: | 1184762403 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D |
License Number: | 007345 |
Business Practice Address: | 2 Haven Ave Suite 217 Port Washington, NY - 110503636 |
Business Phone Number: | 5169443313 |
Business Fax Number: | |
Mailing Address: | 2 Haven Ave, Suite 217 PORT WASHINGTON |
State: | NY |
Postal Code: | 110503636 |
Phone Number: | 5169443313 |
Fax Number: | |
NPI Enumeration Date: | 02/01/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 007345 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |