MEDICARE: DR. SAYIDA YASMIN PEPRAH PSYD

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
1	103TC0700X	Clinical Psychologist	020888	NY

General Provider Information

NPI Number	:	1568694073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAYIDA YASMIN PEPRAH PSYD

Provider Business Mailing Address
First Line	:	80 29TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11232-1503
Country	:	US
Telephone Number	:	718-840-4200
Fax Number	:

Provider Business Practice Location Address
First Line	:	80 29TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11232-1503
Country	:	US
Telephone Number	:	718-840-4200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2009
Last Update Date	:	10/07/2014

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