Healthcare Provider Details

I. General information

NPI: 1396759056
Provider Name (Legal Business Name): NYHMCQ-PSYCHIATRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5645 MAIN ST
FLUSHING NY
11355-5045
US

IV. Provider business mailing address

PO BOX 27842
NEW YORK NY
10087-7842
US

V. Phone/Fax

Practice location:
  • Phone: 718-670-1030
  • Fax: 516-437-4167
Mailing address:
  • Phone: 718-670-1651
  • Fax: 516-437-4167

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MILLIE SCHIFF
Title or Position: DIRECTOR OF BILLING
Credential:
Phone: 718-670-1651