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General NPI Number Information
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NPI Number | 1811937204
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Entity Type | Individual
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Provider Name | TAHER ZANDI PHD
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Gender | Male
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Dates
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Enumeration Date | 06/07/2006
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Last Update Date | 12/11/2013
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Provider Practice Location Address
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Address Line | 110 W BAY PLZ
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City | PLATTSBURGH
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State | NY
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Zip | 12901-1785
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Country | US
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Telephone | 518-561-3707
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Fax | 518-825-3707
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Provider Business Mailing Address
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Address Line | 110 W BAY PLZ
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City | PLATTSBURGH
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State | NY
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Zip | 12901-1785
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Country | US
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Telephone | 518-561-3707
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Fax | 518-825-3707
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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 | 015955
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License Number State | NY
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