Healthcare Provider Details

I. General information

NPI: 1942785571
Provider Name (Legal Business Name): NASYA BREACH PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2018
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 BUNN DR STE 101
PRINCETON NJ
08540-2800
US

IV. Provider business mailing address

166 BUNN DR STE 101
PRINCETON NJ
08540-2800
US

V. Phone/Fax

Practice location:
  • Phone: 609-557-3418
  • Fax:
Mailing address:
  • Phone: 646-709-2715
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number35SI00599000
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License Number35SI00599000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: