Provider Demographics
NPI:1861907065
Name:HISLI SAHIN, NESRIN
Entity type:Individual
Prefix:DR
First Name:NESRIN
Middle Name:
Last Name:HISLI SAHIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 PATRIOT LN
Mailing Address - Street 2:
Mailing Address - City:CEDAR KNOLLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07927-1624
Mailing Address - Country:US
Mailing Address - Phone:862-237-0037
Mailing Address - Fax:
Practice Address - Street 1:285 MADISON AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:NJ
Practice Address - Zip Code:07940-1006
Practice Address - Country:US
Practice Address - Phone:862-237-0037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-10
Last Update Date:2017-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ173-053103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ173-053Other3-YEAR TEMPORARY PERMIT TO PRACTICE PSYCHOLOGY