Provider Demographics
NPI:1699798298
Name:MODY, ZARIN R (PSYD)
Entity type:Individual
Prefix:DR
First Name:ZARIN
Middle Name:R
Last Name:MODY
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 1:350 BLEECKER ST
Mailing Address - Street 2:4T
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-2602
Mailing Address - Country:US
Mailing Address - Phone:212-243-2734
Mailing Address - Fax:
Practice Address - Street 1:350 BLEECKER ST
Practice Address - Street 2:4T
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-2602
Practice Address - Country:US
Practice Address - Phone:212-243-2734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY9788103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist