Individual
DINA EVA KALNICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
521 W 239TH ST, RIVERDALE, NY 10463
(718) 601-7805
Mailing address
1156 N BROADWAY, ANDRUS, YONKERS, NY 10701-1108
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00355940
AGENCY MEDICAID
NY
01
—
1285628552
AGENCY NPI
NY
01
—
WVE061
AGENCY MEDICARE
NY
Enumeration date
10/15/2010
Last updated
10/12/2012
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