Basic Information
| Provider Information | |||||||||
| NPI: | 1548996572 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AHRABI-NEJAD | ||||||||
| FirstName: | CORRINE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 SCOTT LN | ||||||||
| Address2: | |||||||||
| City: | NORTHBOROUGH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 015321124 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5083304787 | ||||||||
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| Practice Location | |||||||||
| Address1: | 161 FORT WASHINGTON AVE | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100323729 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2123059770 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/01/2022 | ||||||||
| LastUpdateDate: | 08/01/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC2200X | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical Child & Adolescent |
No ID Information.