Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XM0800X | Mental Health | 016183 | NY |
NPI | 1710299011 |
---|---|
Provider Name | Miss Sacha Khaloyan |
First Address | Fort Lee, NJ 07024-7056 |
Second Address | New York, NY 10010-4019 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2010 |
Last Update Date | 02/07/2010 |