Healthcare Provider Details
I. General information
NPI: 1003739376
Provider Name (Legal Business Name): SIDEWALK PSYCHOLOGY PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
26 COURT ST
BROOKLYN NY
11242-0103
US
IV. Provider business mailing address
220 5TH AVE FL 11
NEW YORK NY
10001-8017
US
V. Phone/Fax
- Phone: 914-715-5818
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
EMILY
BRACKMAN
Title or Position: OWNER
Credential: PHD
Phone: 914-715-5818