Provider Demographics
NPI:1538568670
Name:BATIZ DOLMO, YADIRA (PSYD)
Entity type:Individual
Prefix:DR
First Name:YADIRA
Middle Name:
Last Name:BATIZ DOLMO
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 1:99 TERRACE VIEW AVE
Mailing Address - Street 2:BRONX
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-5079
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:99 TERRACE VIEW AVE
Practice Address - Street 2:BRONX
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-5079
Practice Address - Country:US
Practice Address - Phone:646-317-4207
Practice Address - Fax:646-317-5014
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-14
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020750103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist