Provider Demographics
NPI:1033317284
Name:ROSS, JULIET MICHELLE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JULIET
Middle Name:MICHELLE
Last Name:ROSS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 W 57TH ST STE 932
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10107-0017
Mailing Address - Country:US
Mailing Address - Phone:917-494-2736
Mailing Address - Fax:212-313-9411
Practice Address - Street 1:250 WEST 57TH STREET
Practice Address - Street 2:SUITE 932
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10107-0017
Practice Address - Country:US
Practice Address - Phone:917-494-2736
Practice Address - Fax:212-313-9411
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017281103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical