Provider Demographics
NPI:1861130684
Name:EKHELIKAR, SANJITA (PSYD)
Entity type:Individual
Prefix:
First Name:SANJITA
Middle Name:
Last Name:EKHELIKAR
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 1:501 5TH AVE RM 1108
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-7880
Mailing Address - Country:US
Mailing Address - Phone:212-271-0216
Mailing Address - Fax:
Practice Address - Street 1:501 5TH AVE RM 1108
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-7880
Practice Address - Country:US
Practice Address - Phone:212-271-0216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-23
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY68-P132267-01103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty