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1619578887
LAWRENCE FANTL
BRONX, NY
NPI
1619578887
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: NY 7556)
Enumeration Date
2020-11-04
Last Update Date
2020-11-04
Business Address
LAWRENCE FANTL
529 COURTLANDT AVE
BRONX, NY 10451-5007
Phone number: 718-993-7700
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Mailing Address
LAWRENCE FANTL
529 COURTLANDT AVE
BRONX, NY 10451-5007
Phone number:
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