Healthcare Provider Details

I. General information

NPI: 1174304281
Provider Name (Legal Business Name): SASHA MANN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2023
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 5TH AVE FL 11
NEW YORK NY
10001-8017
US

IV. Provider business mailing address

220 5TH AVE FL 11
NEW YORK NY
10001-8017
US

V. Phone/Fax

Practice location:
  • Phone: 646-389-7687
  • Fax:
Mailing address:
  • Phone: 646-389-7687
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberP124788
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: