Healthcare Provider Details

I. General information

NPI: 1750066023
Provider Name (Legal Business Name): EF NP IN PSYCHIATRY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2023
Last Update Date: 06/15/2023
Certification Date: 06/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

167 MALONE AVE
STATEN ISLAND NY
10306-4409
US

IV. Provider business mailing address

167 MALONE AVE
STATEN ISLAND NY
10306-4409
US

V. Phone/Fax

Practice location:
  • Phone: 347-497-9916
  • Fax:
Mailing address:
  • Phone: 347-497-9916
  • 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: ELENA FRISH
Title or Position: DIRECTOR
Credential: NP
Phone: 347-497-9916