Basic Information
| Provider Information | |||||||||
| NPI: | 1003015389 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHAMSON | ||||||||
| FirstName: | SANDRA | ||||||||
| MiddleName: | P. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 W 86TH ST | ||||||||
| Address2: | 18-E | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100243303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2128734242 | ||||||||
| FaxNumber: | 2128733676 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 W 86TH ST | ||||||||
| Address2: | 18-E | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100243303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2128734242 | ||||||||
| FaxNumber: | 2128733676 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/16/2007 | ||||||||
| LastUpdateDate: | 07/16/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 009105 | NY | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.