Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 0062281 | NY |
N | 103T00000X | Psychologist | 0062281 | NY |
N | 102L00000X | Psychologist | 355100149100 | NJ |
N | 103T00000X | Psychologist | 355100149100 | NJ |
N | 103G00000X | Clinical Psychologist | 0062281 | NY |
N | 103TC0700X | Clinical Psychologist | 0062281 | NY |
Y | 103G00000X | Clinical Psychologist | 355100149100 | NJ |
Y | 103TC0700X | Clinical Psychologist | 355100149100 | NJ |
N | 103TH0100X | Health Service | 0062281 | NY |
N | 103TH0100X | Health Service | 355100149100 | NJ |
NPI | 1548316953 |
---|---|
Provider Name | Monica Carsky |
First Address | Teaneck, NJ 07666-7242 |
Second Address | Teaneck, NJ 07666-7242 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2007 |
Last Update Date | 14/03/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CA650300 | MEDICARE (01) | NJ |