Basic Information
| Provider Information | |||||||||
| NPI: | 1750428413 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DHARNI | ||||||||
| FirstName: | POONAM | ||||||||
| MiddleName: | BALA | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | LCSW-R | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6207 84TH ST APT E61 | ||||||||
| Address2: | |||||||||
| City: | MIDDLE VILLAGE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113792030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3103839912 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2737 3RD AVE | ||||||||
| Address2: | |||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104515801 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7188381029 | ||||||||
| FaxNumber: | 7188381010 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/31/2007 | ||||||||
| LastUpdateDate: | 12/21/2012 | ||||||||
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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 | 104100000X | 077887 | NY | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.