Healthcare Provider Details

I. General information

NPI: 1255629127
Provider Name (Legal Business Name): THE EPILEPSY INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2011
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

322 8TH AVE STE 202
NEW YORK NY
10001-6852
US

IV. Provider business mailing address

322 8TH AVE STE 202
NEW YORK NY
10001-6852
US

V. Phone/Fax

Practice location:
  • Phone: 212-677-8550
  • Fax: 212-677-5825
Mailing address:
  • Phone: 212-677-8550
  • Fax: 212-677-5825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: BESSIDA A OUEDRAOGO
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 212-677-8550