Provider Demographics
NPI:1407905441
Name:GUR LOBL, MERAV (PHD)
Entity Type:Individual
Prefix:DR
First Name:MERAV
Middle Name:
Last Name:GUR LOBL
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 1:50 E 42ND STREET
Mailing Address - Street 2:SUITE 507
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-5405
Mailing Address - Country:US
Mailing Address - Phone:917-582-2018
Mailing Address - Fax:212-247-2010
Practice Address - Street 1:50 E 42ND ST
Practice Address - Street 2:SUITE 507
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-5405
Practice Address - Country:US
Practice Address - Phone:917-582-2018
Practice Address - Fax:212-247-2010
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0160071103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV672N1Medicare PIN