Provider Demographics
NPI:1083205132
Name:NARIZHNAYA, MARIYA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MARIYA
Middle Name:
Last Name:NARIZHNAYA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 W 97TH STREET
Mailing Address - Street 2:SUITE # 130
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-6330
Mailing Address - Country:US
Mailing Address - Phone:631-323-6580
Mailing Address - Fax:631-850-6433
Practice Address - Street 1:122 W 97TH STREET
Practice Address - Street 2:SUITE # 130
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-1002
Practice Address - Country:US
Practice Address - Phone:631-323-6580
Practice Address - Fax:631-850-6433
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-01
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024146103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty