Provider Demographics
NPI:1487050050
Name:FICHTEL, HEATHER (PSYD)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:
Last Name:FICHTEL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 E 90TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1550
Mailing Address - Country:US
Mailing Address - Phone:212-860-8500
Mailing Address - Fax:212-860-9597
Practice Address - Street 1:114 E 90TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1550
Practice Address - Country:US
Practice Address - Phone:212-860-8500
Practice Address - Fax:212-860-9597
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-10
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020936103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist