Provider Demographics
NPI:1477769719
Name:NEVID, JEFFREY STEVEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:STEVEN
Last Name:NEVID
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:382 CENTRAL PARK W
Mailing Address - Street 2:#11D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-6054
Mailing Address - Country:US
Mailing Address - Phone:212-678-7722
Mailing Address - Fax:718-990-6705
Practice Address - Street 1:382 CENTRAL PARK W
Practice Address - Street 2:#11D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-6054
Practice Address - Country:US
Practice Address - Phone:212-678-7722
Practice Address - Fax:718-990-6705
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005716103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical