Healthcare Provider Details

I. General information

NPI: 1932810744
Provider Name (Legal Business Name): WHOLE BODY PSYCHIATRY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2022
Last Update Date: 12/13/2022
Certification Date: 12/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

352 7TH AVE FL 12A
NEW YORK NY
10001-5893
US

IV. Provider business mailing address

352 7TH AVE FL 12A
NEW YORK NY
10001-5893
US

V. Phone/Fax

Practice location:
  • Phone: 646-543-7224
  • Fax:
Mailing address:
  • Phone: 646-543-7224
  • 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. CLAIRE BRANDON
Title or Position: CEO
Credential: MD
Phone: 646-543-7224