Provider Demographics
NPI:1255642658
Name:CYMERMAN, MIRA HOPE (PSYD)
Entity type:Individual
Prefix:DR
First Name:MIRA
Middle Name:HOPE
Last Name:CYMERMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 DEER RUN
Mailing Address - Street 2:
Mailing Address - City:CHAPPAQUA
Mailing Address - State:NY
Mailing Address - Zip Code:10514-3721
Mailing Address - Country:US
Mailing Address - Phone:914-400-5499
Mailing Address - Fax:
Practice Address - Street 1:75 S BROADWAY STE 415
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-4413
Practice Address - Country:US
Practice Address - Phone:914-400-5499
Practice Address - Fax:914-400-5499
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-30
Last Update Date:2020-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016693103T00000X
NVPY0590103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist