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2001 Palmer Ave Ste 205 Larchmont NY 10538-2420 | |
| (917) 979-8736 | |
| (914) 292-9166 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 2001 Palmer Ave Ste 205, Larchmont, New York |
| Authorized Official Name and Position | Nahal Kaivan (OWNER/CLINIC DIRECTOR) |
| Authorized Official Contact | 8587355425 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
2001 Palmer Ave Ste 205 Larchmont NY 10538-2420 Ph: (917) 979-8736 | 2001 Palmer Ave Ste 205 Larchmont NY 10538-2420 Ph: (917) 979-8736 |
| NPI Number | 1952147449 |
|---|---|
| Provider Enumeration Date | 07/03/2024 |
| Last Update Date | 10/28/2024 |
| Certification Date | 10/26/2024 |
| Medicare PECOS PAC ID | 0345774709 |
|---|---|
| Medicare Enrollment ID | O20241108000119 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952147449 | NPI | - | NPPES |
| Provider Name | Nahal Crystal Kaivan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194203901 PECOS PAC ID: 1254865611 Enrollment ID: I20241108000156 |
| Provider Name | Cheryl Sonilal |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760031306 PECOS PAC ID: 8022543891 Enrollment ID: I20241203002187 |
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