Provider Demographics
NPI:1699864033
Name:COHODAS, JAYNE LEE (PSYD)
Entity type:Individual
Prefix:
First Name:JAYNE
Middle Name:LEE
Last Name:COHODAS
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 1:262 CENTRAL PARK W
Mailing Address - Street 2:#1A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-3512
Mailing Address - Country:US
Mailing Address - Phone:917-328-7318
Mailing Address - Fax:
Practice Address - Street 1:262 CENTRAL PARK W
Practice Address - Street 2:#1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-3512
Practice Address - Country:US
Practice Address - Phone:917-328-7318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012344103G00000X, 103TC2200X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent