Healthcare Provider Details

I. General information

NPI: 1780855213
Provider Name (Legal Business Name): TRANSITIONAL SERVICES FOR NY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2008
Last Update Date: 10/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9027 SUTPHIN BLVD
JAMAICA NY
11435-3631
US

IV. Provider business mailing address

1016 162ND ST
WHITESTONE NY
11357-2124
US

V. Phone/Fax

Practice location:
  • Phone: 718-526-8400
  • Fax:
Mailing address:
  • Phone: 718-746-6647
  • Fax: 718-746-6799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MR. STAN CORFMAN
Title or Position: CFO
Credential:
Phone: 718-746-6647