Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 016752 | NY |
N | 103TC0700X | Clinical Psychologist | 016752 | NY |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 016752 | NY |
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 016752 | NY |
NPI | 1154677151 |
---|---|
Provider Name | Dr. Nehal P Vadhan |
First Address | Great Neck, NY 11021-2417 |
Second Address | Great Neck, NY 11021-2417 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2012 |
Last Update Date | 26/03/2018 |