1457540577 NPI number — PSYCHOLOGICAL ASSESSMENTS & SOLUTIONS, PC

Table of content: (NPI 1457540577)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457540577 NPI number — PSYCHOLOGICAL ASSESSMENTS & SOLUTIONS, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PSYCHOLOGICAL ASSESSMENTS & SOLUTIONS, PC
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:
1457540577
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/02/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
106 CHARLES ST
Provider Second Line Business Mailing Address:
SUITE NO. 3
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10014-2668
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-691-0291
Provider Business Mailing Address Fax Number:
212-691-0291

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
106 CHARLES ST
Provider Second Line Business Practice Location Address:
SUITE NO. 3
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10014-2668
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-691-0291
Provider Business Practice Location Address Fax Number:
212-691-0291
Provider Enumeration Date:
10/15/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HOHN
Authorized Official First Name:
GABRIELA
Authorized Official Middle Name:
EMMI
Authorized Official Title or Position:
LICENSED PSYCHOLOGIST, PRESIDENT
Authorized Official Telephone Number:
212-691-0291

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  13357 , 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: 02157844 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 274541000 . This is a "MAGELLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 158587 . This is a "VALUEOPTIONS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 3046038 . This is a "AETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: V375F . This is a "EMPIRE BLUE CROSS/SHIELD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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