Provider Demographics
NPI:1861656225
Name:KRAVITZ, MEREDYTH D (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MEREDYTH
Middle Name:D
Last Name:KRAVITZ
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 1:945 5TH AVE OFC 5
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-2667
Mailing Address - Country:US
Mailing Address - Phone:212-439-8430
Mailing Address - Fax:
Practice Address - Street 1:945 5TH AVE OFC 5
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-2667
Practice Address - Country:US
Practice Address - Phone:212-439-8430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-15
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016448103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent