Provider Demographics
NPI:1679001077
Name:RAMINFAR PSYCHOLOGY PLLC
Entity Type:Organization
Organization Name:RAMINFAR PSYCHOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:
Authorized Official - Last Name:PEARL-RAMINFAR
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:718-419-9859
Mailing Address - Street 1:1661 E 12TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1011
Mailing Address - Country:US
Mailing Address - Phone:718-419-9859
Mailing Address - Fax:
Practice Address - Street 1:2460 FLATBUSH AVE STE 10
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-5015
Practice Address - Country:US
Practice Address - Phone:718-419-9859
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-30
Last Update Date:2017-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021942103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty