Provider Demographics
NPI:1710104963
Name:SIDALI, DENIZ
Entity Type:Individual
Prefix:
First Name:DENIZ
Middle Name:
Last Name:SIDALI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9411 59TH AVE APT C20
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-5103
Mailing Address - Country:US
Mailing Address - Phone:718-592-8524
Mailing Address - Fax:
Practice Address - Street 1:465 GRAND ST FL 2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-4800
Practice Address - Country:US
Practice Address - Phone:212-420-1970
Practice Address - Fax:212-420-1906
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist