| New York State Neuropsychological State Of Mind Pc | |
|
8460 123rd St Kew Gardens NY 11415-3305 | |
| (718) 441-0166 | |
| (718) 805-2054 |
| Full Name | New York State Neuropsychological State Of Mind Pc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 8460 123rd St, Kew Gardens, New York |
| Authorized Official Name and Position | Sanam Hafeez (PSY.D) |
| Authorized Official Contact | 7184410166 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| New York State Neuropsychological State Of Mind Pc 8460 123rd St Kew Gardens NY 11415-3305 Ph: (718) 441-0166 | New York State Neuropsychological State Of Mind Pc 8460 123rd St Kew Gardens NY 11415-3305 Ph: (718) 441-0166 |
| NPI Number | 1013414705 |
|---|---|
| Provider Enumeration Date | 04/09/2018 |
| Last Update Date | 04/09/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013414705 | NPI | - | NPPES |
| 02936607 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 016117 (New York) | Primary |
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