Provider Demographics
NPI:1346679032
Name:YASAI, MOUGEH (PHD)
Entity Type:Individual
Prefix:DR
First Name:MOUGEH
Middle Name:
Last Name:YASAI
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 1:352 7TH AVENUE
Mailing Address - Street 2:SUITE 1005
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001
Mailing Address - Country:US
Mailing Address - Phone:646-342-4393
Mailing Address - Fax:
Practice Address - Street 1:352 7TH AVE
Practice Address - Street 2:SUITE 1005
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-5012
Practice Address - Country:US
Practice Address - Phone:646-342-4393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist