Provider Demographics
NPI:1427181114
Name:BELL, MICHELLE ANNE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:ANNE
Last Name:BELL
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 1:4700 BROADWAY #1A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10040
Mailing Address - Country:US
Mailing Address - Phone:917-232-2248
Mailing Address - Fax:646-678-4583
Practice Address - Street 1:4700 BROADWAY #1A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10040
Practice Address - Country:US
Practice Address - Phone:917-232-2248
Practice Address - Fax:646-678-4583
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016072-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist