Provider Demographics
NPI:1063149110
Name:MAHRAN, GHALIA T
Entity type:Individual
Prefix:
First Name:GHALIA
Middle Name:T
Last Name:MAHRAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:477 MADISON AVE STE 6812
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-5802
Mailing Address - Country:US
Mailing Address - Phone:332-282-5900
Mailing Address - Fax:
Practice Address - Street 1:477 MADISON AVE STE 6812
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-5802
Practice Address - Country:US
Practice Address - Phone:332-282-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health