Healthcare Provider Details

I. General information

NPI: 1649965898
Provider Name (Legal Business Name): PSYCHOLOGICAL ASSESSMENTS AND CONSULTATION SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2023
Last Update Date: 04/05/2023
Certification Date: 04/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 W 86TH ST APT 9C
NEW YORK NY
10024-3664
US

IV. Provider business mailing address

700 FORT WASHINGTON AVE APT 5J
NEW YORK NY
10040-3706
US

V. Phone/Fax

Practice location:
  • Phone: 347-696-1477
  • Fax:
Mailing address:
  • Phone: 347-696-1477
  • 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. EUGENIA DUBUS
Title or Position: DIRECTOR
Credential: PH.D.
Phone: 347-696-1477