Provider Demographics
NPI:1730951542
Name:MASEROW, JOSHUA (PHD, CLINICAL PSYCH)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:
Last Name:MASEROW
Suffix:
Gender:M
Credentials:PHD, CLINICAL PSYCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 W 60TH ST APT 16T
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-7513
Mailing Address - Country:US
Mailing Address - Phone:646-617-5790
Mailing Address - Fax:
Practice Address - Street 1:345 E 102ND ST FL 2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-5611
Practice Address - Country:US
Practice Address - Phone:212-241-8462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP125080103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical