Provider Demographics
NPI:1760042733
Name:SANANDAJI, YASMINE
Entity Type:Individual
Prefix:
First Name:YASMINE
Middle Name:
Last Name:SANANDAJI
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 1:31 W 34TH ST RM 1012
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-3268
Mailing Address - Country:US
Mailing Address - Phone:732-523-1245
Mailing Address - Fax:732-400-9170
Practice Address - Street 1:31 W 34TH ST RM 1012
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-3268
Practice Address - Country:US
Practice Address - Phone:732-523-1245
Practice Address - Fax:732-400-9170
Is Sole Proprietor?:No
Enumeration Date:2019-06-20
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1-18-33010103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst