Organization
NEW YORK STATE NEUROPSYCHOLOGICAL STATE OF MIND PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANAM HAFEEZ (PSY.D)
(718) 441-0166
Entity
Organization
Contact information
Practice address
8460 123RD ST, KEW GARDENS, NY 11415-3305
(718) 441-0166
(718) 805-2054
Mailing address
8460 123RD ST, KEW GARDENS, NY 11415-3305
(718) 441-0166
(718) 805-2054
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
016117
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02936607
—
NY
Enumeration date
04/09/2018
Last updated
04/09/2018
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