Provider Demographics
NPI:1538357967
Name:YASIK, ANASTASIA E (PHD)
Entity type:Individual
Prefix:DR
First Name:ANASTASIA
Middle Name:E
Last Name:YASIK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 E 78TH ST
Mailing Address - Street 2:#6D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-1659
Mailing Address - Country:US
Mailing Address - Phone:212-861-5147
Mailing Address - Fax:212-346-1618
Practice Address - Street 1:83 MAIDEN LN
Practice Address - Street 2:AHRC - 5TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-4812
Practice Address - Country:US
Practice Address - Phone:212-780-2565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-10
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY01425-1103T00000X
DEB1-0000657103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist