Provider Demographics
NPI:1568592608
Name:GHAHARY, NOURIMAN - (PHD)
Entity Type:Individual
Prefix:DR
First Name:NOURIMAN
Middle Name:-
Last Name:GHAHARY
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 1:565 GROVE ST
Mailing Address - Street 2:APT. F13
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-3142
Mailing Address - Country:US
Mailing Address - Phone:973-471-4246
Mailing Address - Fax:
Practice Address - Street 1:103 PARK ST
Practice Address - Street 2:SUITE 2A
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-5913
Practice Address - Country:US
Practice Address - Phone:201-956-8833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ4404103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling