Healthcare Provider Details

I. General information

NPI: 1275161119
Provider Name (Legal Business Name): CARNEGIE HILL PSYCHOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2020
Last Update Date: 03/27/2020
Certification Date: 03/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 E 92ND ST STE 1A
NEW YORK NY
10128-1688
US

IV. Provider business mailing address

115 E 92ND ST STE 1A
NEW YORK NY
10128-1688
US

V. Phone/Fax

Practice location:
  • Phone: 917-648-4904
  • Fax:
Mailing address:
  • Phone: 917-648-4904
  • Fax:

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: DR. MICHELE B. SMITH
Title or Position: PSYCHOLOGIST
Credential: PHD
Phone: 917-648-4904