Provider Demographics
NPI:1255350799
Name:PAPPAS, EVA (PH,D)
Entity type:Individual
Prefix:DR
First Name:EVA
Middle Name:
Last Name:PAPPAS
Suffix:
Gender:F
Credentials:PH,D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 IRVING PL APT 1B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-2209
Mailing Address - Country:US
Mailing Address - Phone:212-475-8614
Mailing Address - Fax:
Practice Address - Street 1:81 IRVING PL APT 1B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-2209
Practice Address - Country:US
Practice Address - Phone:212-475-8614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005093-1103TC0700X
NY437-1102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01540427Medicaid
NY01540427Medicaid