Provider Demographics
NPI:1467885723
Name:HAJIZADEH, NEDA (PHD)
Entity Type:Individual
Prefix:DR
First Name:NEDA
Middle Name:
Last Name:HAJIZADEH
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 1:715 BROADWAY
Mailing Address - Street 2:RM 532
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-6806
Mailing Address - Country:US
Mailing Address - Phone:805-931-6332
Mailing Address - Fax:
Practice Address - Street 1:715 BROADWAY
Practice Address - Street 2:RM 532
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-6806
Practice Address - Country:US
Practice Address - Phone:805-931-6332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-09
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018618103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling