Provider Demographics
NPI:1295949071
Name:HANESIAN, HELEN (EDD)
Entity type:Individual
Prefix:DR
First Name:HELEN
Middle Name:
Last Name:HANESIAN
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE WASHINGTON SQUARE VILLAGE
Mailing Address - Street 2:STE 6-G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-1632
Mailing Address - Country:US
Mailing Address - Phone:212-982-0782
Mailing Address - Fax:
Practice Address - Street 1:ONE WASHINGTON SQUARE VILLAGE
Practice Address - Street 2:STE 6-G
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-1632
Practice Address - Country:US
Practice Address - Phone:212-982-0782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJS100827103T00000X
NY0038471103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
160230OtherVALUE OPTION
0063103OtherGHI
0063103OtherGHI