MEDICARE: DR. PATRICK HAENLEIN JR. M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	301308	NY
2	103TP0016X	Prescribing (Medical) Psychologist	301308	NY

General Provider Information

NPI Number	:	1518311927
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICK HAENLEIN JR. M.D.

Provider Business Mailing Address
First Line	:	1000 10TH AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10019-1147
Country	:	US
Telephone Number	:	212-523-4000
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 10TH AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10011-4718
Country	:	US
Telephone Number	:	212-523-6775
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/21/2016
Last Update Date	:	03/11/2025

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