Provider Demographics
NPI:1578056099
Name:DRENGER, MICHAL (PHD)
Entity Type:Individual
Prefix:DR
First Name:MICHAL
Middle Name:
Last Name:DRENGER
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 1:306 2ND ST APT 4B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-2484
Mailing Address - Country:US
Mailing Address - Phone:347-331-1350
Mailing Address - Fax:
Practice Address - Street 1:77 BLEECKER ST APT C111
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-1586
Practice Address - Country:US
Practice Address - Phone:347-331-1350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-09
Last Update Date:2018-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021749-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical