1548297997 NPI number — NEW YORK PSYCHOLOGICAL AND BEHAVIORAL SERVICES

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548297997 NPI number — NEW YORK PSYCHOLOGICAL AND BEHAVIORAL SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW YORK PSYCHOLOGICAL AND BEHAVIORAL SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1548297997
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
585 SCHENECTADY AVE
Provider Second Line Business Mailing Address:
NYPBS/SLEEP
Provider Business Mailing Address City Name:
BROOKLYN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11203
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-951-0236
Provider Business Mailing Address Fax Number:
718-951-0238

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2306 NOSTRAND AVENUE
Provider Second Line Business Practice Location Address:
BETWEEN AVE I AND J
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-951-0236
Provider Business Practice Location Address Fax Number:
718-951-0238
Provider Enumeration Date:
06/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
JEAN-LOUIS
Authorized Official First Name:
GIRARDIN
Authorized Official Middle Name:
Authorized Official Title or Position:
PSYCHOLOGIST
Authorized Official Telephone Number:
718-951-0236

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  015542 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 02571108 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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