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General NPI Number Information
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NPI Number | 1295138717
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Entity Type | Individual
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Provider Name | PARASTOO PAMELA GHAZI PH.D.
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Gender | Female
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Dates
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Enumeration Date | 09/29/2014
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Last Update Date | 10/11/2018
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Provider Practice Location Address
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Address Line | 14 TRUMBULL ST # 112
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City | NEW HAVEN
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State | CT
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Zip | 06511-6312
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Country | US
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Telephone | 860-980-0813
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Fax |
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Provider Business Mailing Address
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Address Line | 37 WINDING TRL
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City | CHESHIRE
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State | CT
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Zip | 06410-3324
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Country | US
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Telephone | 703-203-7878
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0810005089
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 003769
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License Number State | CT
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