Provider Demographics
NPI:1295844181
Name:PAYAMPS, NELSON ROBERT
Entity Type:Individual
Prefix:MR
First Name:NELSON
Middle Name:ROBERT
Last Name:PAYAMPS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:NELSON
Other - Middle Name:
Other - Last Name:PAYAMPS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW DCSW
Mailing Address - Street 1:53 OAK RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10570-1307
Mailing Address - Country:US
Mailing Address - Phone:914-741-2329
Mailing Address - Fax:
Practice Address - Street 1:400 E FORDHAM RD
Practice Address - Street 2:BRONX MHS OF HIP
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-5039
Practice Address - Country:US
Practice Address - Phone:718-364-3500
Practice Address - Fax:718-367-2092
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0287941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical