Individual
JESSICA N TASCA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1840 211TH ST APT 6C, BAYSIDE, NY 11360-1806
(845) 325-0245
Mailing address
153 FAIRVIEW AVE, SOUTH ORANGE, NJ 07079-2524
(845) 325-0245
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
025150
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
025150
NYS LICENSE
NY
Enumeration date
09/05/2022
Last updated
09/05/2022
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