Healthcare Provider Details

I. General information

NPI: 1457418337
Provider Name (Legal Business Name): TRANSITIONAL SERVICES FOR NEW YORK, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 06/06/2023
Certification Date: 06/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9027 SUTPHIN BLVD STE 5
JAMAICA NY
11435-3648
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:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNY

VIII. Authorized Official

Name: LARRY STEVEN GRUBLER
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: PSY.D.
Phone: 718-746-6647