Provider Demographics
NPI:1316285273
Name:PISANO, NIRIT GRADWOHL (PHD)
Entity type:Individual
Prefix:DR
First Name:NIRIT
Middle Name:GRADWOHL
Last Name:PISANO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 POPHAM RD
Mailing Address - Street 2:SUITE 1E
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-4252
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:45 POPHAM RD
Practice Address - Street 2:SUITE 1E
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-4252
Practice Address - Country:US
Practice Address - Phone:914-721-0406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-27
Last Update Date:2013-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019943103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical