Healthcare Provider Details

I. General information

NPI: 1578112215
Provider Name (Legal Business Name): MERCEDES J OKOSI PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2019
Last Update Date: 09/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 5TH AVE FL 3
NEW YORK NY
10016-8728
US

IV. Provider business mailing address

41 E 11TH ST FL 7
NEW YORK NY
10003-4602
US

V. Phone/Fax

Practice location:
  • Phone: 646-689-6746
  • Fax:
Mailing address:
  • Phone: 646-689-6746
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number023381
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: