Provider Demographics
NPI:1205001096
Name:PASTERNACK, LINDA (PHD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:
Last Name:PASTERNACK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 UNION ST
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-2124
Mailing Address - Country:US
Mailing Address - Phone:973-746-0086
Mailing Address - Fax:973-746-7986
Practice Address - Street 1:26 W 9TH ST
Practice Address - Street 2:SUITE 2D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8971
Practice Address - Country:US
Practice Address - Phone:212-691-0252
Practice Address - Fax:973-746-7986
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005725-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health