Healthcare Provider Details

I. General information

NPI: 1821315508
Provider Name (Legal Business Name): ROCKLAND PSYCHIATRIC CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2010
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 OLD ORANGEBURG RD 8TH FLOOR
ORANGEBURG NY
10962-1157
US

IV. Provider business mailing address

140 OLD ORANGEBURG RD 8TH FLOOR
ORANGEBURG NY
10962-1157
US

V. Phone/Fax

Practice location:
  • Phone: 845-680-8094
  • Fax: 845-680-5580
Mailing address:
  • Phone: 845-680-8094
  • Fax: 845-680-5580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number003146
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number5
License Number StateNY

VIII. Authorized Official

Name: DR. JUDITH ANNE NAGIB
Title or Position: PSYCHOLOGIST
Credential: PH.D.
Phone: 845-680-8094