Basic Information
| Provider Information | |||||||||
| NPI: | 1184961393 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NADAN | ||||||||
| FirstName: | PAMELA | ||||||||
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| Credential: | PSYD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 140 HARDSCRABBLE LAKE DR | ||||||||
| Address2: | |||||||||
| City: | CHAPPAQUA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105143043 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9147377338 | ||||||||
| FaxNumber: | 9147371050 | ||||||||
| Practice Location | |||||||||
| Address1: | 1101 MAIN ST | ||||||||
| Address2: | C/O WJCS | ||||||||
| City: | PEEKSKILL | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105662907 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9147377338 | ||||||||
| FaxNumber: | 9147371050 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/08/2013 | ||||||||
| LastUpdateDate: | 01/08/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | 019929 | NY | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.