Provider Demographics
NPI:1346441920
Name:JIMENEZ, DAYANA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DAYANA
Middle Name:
Last Name:JIMENEZ
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 1:3959 BROADWAY
Mailing Address - Street 2:CHILDREN'S HOSPITAL OF NY PRESBYTERIAN
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-1559
Mailing Address - Country:US
Mailing Address - Phone:212-342-3306
Mailing Address - Fax:212-305-6614
Practice Address - Street 1:CHIDREN'S HOSPITAL OF NY PRESBYTERIAN
Practice Address - Street 2:3959 BROADWAY AVENUE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032
Practice Address - Country:US
Practice Address - Phone:212-342-3306
Practice Address - Fax:212-305-6614
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014977103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent