Provider Demographics
NPI:1891851077
Name:FIELDS, ERIC BRIAN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:BRIAN
Last Name:FIELDS
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 E 94TH ST APT 2A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-5686
Mailing Address - Country:US
Mailing Address - Phone:347-801-7176
Mailing Address - Fax:
Practice Address - Street 1:330 E 94TH ST APT 2A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-5686
Practice Address - Country:US
Practice Address - Phone:347-801-7176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017375103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist