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General NPI Number Information
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NPI Number | 1659494177
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Entity Type | Individual
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Provider Name | MEENA DASARI PH.D.
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Gender | Female
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 39 E 78TH ST SUITE 501
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City | NEW YORK
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State | NY
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Zip | 10021-0213
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Country | US
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Telephone | 917-734-3333
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Fax |
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Provider Business Mailing Address
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Address Line | 200 E 87TH ST APT 12A
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City | NEW YORK
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State | NY
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Zip | 10128-3112
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Country | US
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Telephone | 212-263-7312
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Fax | 212-263-7806
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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 | 016495
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License Number State | NY
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