Healthcare Provider Details

I. General information

NPI: 1548297997
Provider Name (Legal Business Name): NEW YORK PSYCHOLOGICAL AND BEHAVIORAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2306 NOSTRAND AVENUE BETWEEN AVE I AND J
BROOKLYN NY
11210
US

IV. Provider business mailing address

585 SCHENECTADY AVE NYPBS/SLEEP
BROOKLYN NY
11203
US

V. Phone/Fax

Practice location:
  • Phone: 718-951-0236
  • Fax: 718-951-0238
Mailing address:
  • Phone: 718-951-0236
  • Fax: 718-951-0238

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number015542
License Number StateNY

VIII. Authorized Official

Name: GIRARDIN JEAN-LOUIS
Title or Position: PSYCHOLOGIST
Credential: PH.D.
Phone: 718-951-0236