Basic Information
Provider Information
NPI: 1134248834
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DOGNIN
FirstName: JOANNA
MiddleName: SANDRA
NamePrefix: DR.
NameSuffix:  
Credential: PSY.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: LOBOZZO
OtherFirstName: JOANNA
OtherMiddleName: SANDRA
OtherNamePrefix: DR.
OtherNameSuffix:  
OtherCredential: PSY.D.
OtherLastNameType: 1
Mailing Information
Address1: 423 E 23RD ST
Address2: DEPT OF VA/NY HARBOR HEALTHCARE SYSTEM/MH SERVICE
City: NEW YORK
State: NY
PostalCode: 100105011
CountryCode: US
TelephoneNumber: 2126867500
FaxNumber:  
Practice Location
Address1: 423 E 23RD ST
Address2: DEPT OF VA/NY HARBOR HEALTHCARE SYSTEM/MH SERVICE
City: NEW YORK
State: NY
PostalCode: 100105011
CountryCode: US
TelephoneNumber: 2126867500
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/27/2007
LastUpdateDate: 09/01/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103TC0700X015099-1NYY Behavioral Health & Social Service ProvidersPsychologistClinical

No ID Information.


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