Provider Demographics
NPI:1255463535
Name:KRICHMAR-LIVERANT, LANA (PHD)
Entity type:Individual
Prefix:
First Name:LANA
Middle Name:
Last Name:KRICHMAR-LIVERANT
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 1:451 CLARKSON AVE
Mailing Address - Street 2:R - 7005D
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-2054
Mailing Address - Country:US
Mailing Address - Phone:718-245-2519
Mailing Address - Fax:718-613-8213
Practice Address - Street 1:451 CLARKSON AVE
Practice Address - Street 2:R BUILDING
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2054
Practice Address - Country:US
Practice Address - Phone:718-245-2519
Practice Address - Fax:718-613-8213
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015185-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical