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General NPI Number Information
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NPI Number | 1154677151
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Entity Type | Individual
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Provider Name | NEHAL P VADHAN PH.D.
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Gender | Male
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Dates
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Enumeration Date | 07/27/2012
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Last Update Date | 03/26/2018
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Provider Practice Location Address
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Address Line | 11 GRACE AVE STE 204
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City | GREAT NECK
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State | NY
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Zip | 11021-2417
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Country | US
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Telephone | 917-371-3888
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Fax |
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Provider Business Mailing Address
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Address Line | 11 GRACE AVE STE 204
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City | GREAT NECK
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State | NY
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Zip | 11021-2417
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Country | US
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Telephone | 917-371-3888
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 016752
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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License Number | 016752
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | 016752
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License Number State | NY
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