Healthcare Provider Details

I. General information

NPI: 1437313822
Provider Name (Legal Business Name): PSCH. INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2008
Last Update Date: 02/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

153-17 JAMAICA AVE FL3
JAMAICA NY
11432-3822
US

IV. Provider business mailing address

142-02 20TH AVENUE
FLUSHING NY
11351-9712
US

V. Phone/Fax

Practice location:
  • Phone: 718-297-1718
  • Fax: 718-297-2264
Mailing address:
  • Phone: 718-559-0516
  • Fax: 718-762-6140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. JACQUELINE RIVERA-HERRERA
Title or Position: VP FINANCE CLINICAL SERVICES
Credential:
Phone: 347-542-4217