1578654000 NPI number — ROCKLAND PSYCHIATRIC CENTER

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 1578654000 NPI number — ROCKLAND PSYCHIATRIC CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROCKLAND PSYCHIATRIC CENTER
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:
6
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:
1578654000
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/14/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
140 OLD ORANGEBURG ROAD
Provider Second Line Business Mailing Address:
ROCKLAND PSYCHIATRIC CENTER
Provider Business Mailing Address City Name:
ORANGEBURG
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10962
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-359-1000
Provider Business Mailing Address Fax Number:
845-680-5516

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18 CHURCH STREET
Provider Second Line Business Practice Location Address:
NYACK CONSULTATION CENTER
Provider Business Practice Location Address City Name:
NYACK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10960
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-358-1677
Provider Business Practice Location Address Fax Number:
845-358-3640
Provider Enumeration Date:
09/28/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BOTROS
Authorized Official First Name:
LAMIA
Authorized Official Middle Name:
KARMAL
Authorized Official Title or Position:
PSYCHIATRIST
Authorized Official Telephone Number:
845-358-1677

Provider Taxonomy Codes

  • Taxonomy code: 283Q00000X , with the licence number:  NY214224 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 283Q00000X , with the licence number: 214224 , 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)