Healthcare Provider Details
I. General information
NPI: 1588375257
Provider Name (Legal Business Name): NY PSYCHOLOGY SERVICES P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/13/2022
Last Update Date: 12/13/2022
Certification Date: 12/13/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
62 HILLTOP DR
CHAPPAQUA NY
10514-1917
US
IV. Provider business mailing address
822 GUILFORD AVE # 1500
BALTIMORE MD
21202-3707
US
V. Phone/Fax
- Phone: 646-584-6354
- Fax:
- Phone: 800-402-8768
- 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:
CATHERINE
MCKNIGHT WOLFSON
Title or Position: PRESIDENT
Credential:
Phone: 646-584-6354