Basic Information
| Provider Information | |||||||||
| NPI: | 1689824120 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ASPEN | ||||||||
| FirstName: | JANET | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PH.,D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 34 S BROADWAY | ||||||||
| Address2: | SUITE #600 | ||||||||
| City: | WHITE PLAINS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 106014400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146819435 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 34 S BROADWAY | ||||||||
| Address2: | SUITE #600 | ||||||||
| City: | WHITE PLAINS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 106014400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146819435 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2008 | ||||||||
| LastUpdateDate: | 09/20/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 017791 | NY | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
ID Information
| ID | Type | State | Issuer | Description | 01779101 | 01 | NY | NYS LICENSE | OTHER |