Provider Demographics
NPI:1184762403
Name:BRAVMANN, CAROL RUTH (PHD)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:RUTH
Last Name:BRAVMANN
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 1:17 BARSTOW RD STE 309
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-2213
Mailing Address - Country:US
Mailing Address - Phone:516-944-3313
Mailing Address - Fax:
Practice Address - Street 1:17 BARSTOW RD STE 309
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-2213
Practice Address - Country:US
Practice Address - Phone:516-944-3313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007345103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical