Provider Demographics
NPI:1386857423
Name:HATZOR, TALIA (PHD)
Entity type:Individual
Prefix:DR
First Name:TALIA
Middle Name:
Last Name:HATZOR
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 1:207 W 86TH ST
Mailing Address - Street 2:APT. 116
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-3340
Mailing Address - Country:US
Mailing Address - Phone:212-769-1486
Mailing Address - Fax:
Practice Address - Street 1:210 W 89TH ST
Practice Address - Street 2:SUITE 1E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-1805
Practice Address - Country:US
Practice Address - Phone:212-769-2689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014360103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist