Provider Demographics
NPI:1760880934
Name:AVINADAV, RONI (PHD)
Entity Type:Individual
Prefix:DR
First Name:RONI
Middle Name:
Last Name:AVINADAV
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:PO BOX 231144
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-0020
Mailing Address - Country:US
Mailing Address - Phone:917-510-4823
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 231144
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-0020
Practice Address - Country:US
Practice Address - Phone:917-510-4823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-19
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018935-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical