Provider Demographics
NPI:1679605216
Name:BROTHERS, DORIS (PHD)
Entity type:Individual
Prefix:DR
First Name:DORIS
Middle Name:
Last Name:BROTHERS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 W 90TH ST
Mailing Address - Street 2:APT. 3F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-1504
Mailing Address - Country:US
Mailing Address - Phone:212-864-6333
Mailing Address - Fax:212-202-4123
Practice Address - Street 1:350 CENTRAL PARK W
Practice Address - Street 2:SUITE 1AD
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-6547
Practice Address - Country:US
Practice Address - Phone:212-864-6333
Practice Address - Fax:212-202-4123
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007723-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical