MEDICARE: SCHWALBE PSYCHOLOGICAL SERVICES, P.C.

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	261QM0850X	Adult Mental Health Clinic/Center	017479	NY

General Provider Information

NPI Number	:	1831357813
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCHWALBE PSYCHOLOGICAL SERVICES, P.C.

Provider Business Mailing Address
First Line	:	353 LEXINGTON AVE
Second Line	:	SUITE 1004
City	:	NEW YORK
State	:	NY
Zip	:	10016-0941
Country	:	US
Telephone Number	:	212-972-0747
Fax Number	:

Provider Business Practice Location Address
First Line	:	353 LEXINGTON AVE
Second Line	:	SUITE 1004
City	:	NEW YORK
State	:	NY
Zip	:	10016-0941
Country	:	US
Telephone Number	:	212-972-0747
Fax Number	:

Authorized Official
Title or Position	:	LICENSED CLINICAL PSYCHOLOGIST
Name	:	DR. EVAN SCHWALBE
Credential	:	PHD
Telephone Number	:	212-972-0747

Provider Enumeration Date	:	05/27/2008
Last Update Date	:	05/27/2008

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