Provider Demographics
NPI:1467710343
Name:HALBERSTAM, DINIA (MS)
Entity Type:Individual
Prefix:
First Name:DINIA
Middle Name:
Last Name:HALBERSTAM
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 BLAUVELT RD UNIT 102
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-2574
Mailing Address - Country:US
Mailing Address - Phone:845-371-8323
Mailing Address - Fax:
Practice Address - Street 1:222 BLAUVELT RD UNIT 102
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-2574
Practice Address - Country:US
Practice Address - Phone:845-371-8323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-27
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist