Provider Demographics
NPI:1164554002
Name:WATSON, ROBERT I JR (PHD)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:I
Last Name:WATSON
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 E 60TH ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1002
Mailing Address - Country:US
Mailing Address - Phone:212-326-8441
Mailing Address - Fax:
Practice Address - Street 1:16 E 60TH ST
Practice Address - Street 2:SUITE 400
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1002
Practice Address - Country:US
Practice Address - Phone:212-326-8441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5183103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical