Provider Demographics
NPI:1811356231
Name:BRONER, NAHAMA (PHD)
Entity type:Individual
Prefix:
First Name:NAHAMA
Middle Name:
Last Name:BRONER
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 1:526 W 26TH ST
Mailing Address - Street 2:SUITE 621
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-5517
Mailing Address - Country:US
Mailing Address - Phone:646-236-2043
Mailing Address - Fax:
Practice Address - Street 1:526 W 26TH ST
Practice Address - Street 2:SUITE 621
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-5517
Practice Address - Country:US
Practice Address - Phone:646-236-2043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-12
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011473103TC2200X, 103TF0200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic