Provider Demographics
NPI:1013926641
Name:VINOGRADE, DENISE SENDER (PHD)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:SENDER
Last Name:VINOGRADE
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 1:225 W 71ST ST
Mailing Address - Street 2:SUITE 23
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-3726
Mailing Address - Country:US
Mailing Address - Phone:212-873-2046
Mailing Address - Fax:
Practice Address - Street 1:225 W 71ST ST
Practice Address - Street 2:SUITE 23
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-3726
Practice Address - Country:US
Practice Address - Phone:212-873-2046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015183103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02408217Medicaid
NY02408217Medicaid