Provider Demographics
NPI:1760823389
Name:CROSBY, JOHN B III (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:B
Last Name:CROSBY
Suffix:III
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:JAY
Other - Middle Name:
Other - Last Name:CROSBY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:6 E 39TH ST STE 1100
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-0112
Mailing Address - Country:US
Mailing Address - Phone:646-820-7389
Mailing Address - Fax:
Practice Address - Street 1:6 E 39TH ST STE 1100
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-0112
Practice Address - Country:US
Practice Address - Phone:646-820-7389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-11
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020216103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical