Provider Information for 1689936668
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Dr. JED A LIVINGSTON Psy.D.
Sex: Male
NPI: 1689936668
Last Updated: 2012-06-14
Certification Date:
Certification Date:
Details
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NPI | 1689936668 | ||||||||
Enumeration Date | 2012-06-14 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | YES | ||||||||
Status | Active | ||||||||
Mailing Address | 171 CLERMONT AVE APT. #6O BROOKLYN, NY 11205-3316 United States Phone: 917-582-9020 | Fax: | ||||||||
Primary Practice Address | 171 CLERMONT AVE APT. #6O BROOKLYN, NY 11205-3316 United States Phone: 917-582-9020 | Fax: | ||||||||
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