Healthcare Provider Details

I. General information

NPI: 1568824639
Provider Name (Legal Business Name): MAP NY CONSULTING, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2016
Last Update Date: 04/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

365 SUNRISE HWY
LYNBROOK NY
11563-3027
US

IV. Provider business mailing address

365 SUNRISE HWY
LYNBROOK NY
11563-3027
US

V. Phone/Fax

Practice location:
  • Phone: 516-737-7018
  • Fax: 516-331-3175
Mailing address:
  • Phone: 516-737-7018
  • Fax: 516-331-3175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number401811
License Number StateNY

VIII. Authorized Official

Name: MARY ANN PESTRAK
Title or Position: PSYCHIATRIC NURSE PRACTITIONER
Credential: APRN
Phone: 516-737-7018