Provider Demographics
NPI:1316083009
Name:HAUGEN, PETER TEJAS (PHD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:TEJAS
Last Name:HAUGEN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:687 DEGRAW ST # 3
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-3111
Mailing Address - Country:US
Mailing Address - Phone:718-483-2159
Mailing Address - Fax:
Practice Address - Street 1:462 1ST AVE
Practice Address - Street 2:BELLEVUE HOSPITAL CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-9196
Practice Address - Country:US
Practice Address - Phone:212-562-2230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017231103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical