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NPI Code Detail

MEDICARE: DR. SHAHRZAD SADIGHIM PSY.D.

MEDICARE:  DR. SHAHRZAD  SADIGHIM  PSY.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2103TC0700XClinical Psychologist022-890-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
183-3536193OTHERNYPLLC

General Provider Information

NPI Number : 1003159310
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHAHRZAD SADIGHIM PSY.D.
Provider Business Mailing Address
First Line : 808 UNION ST STE 3A
Second Line :
City : BROOKLYN
State : NY
Zip : 11215-1386
Country : US
Telephone Number : 516-382-3433
Fax Number :
Provider Business Practice Location Address
First Line : 26 COURT ST STE 1302
Second Line :
City : BROOKLYN
State : NY
Zip : 11242-1113
Country : US
Telephone Number : 516-382-3343
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2013
Last Update Date : 03/28/2023

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