Healthcare Provider Details
I. General information
NPI: 1952238495
Provider Name (Legal Business Name): NEW YORK INTERVENTIONAL PSYCHIATRY GROUP, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
34 S BROADWAY STE 504
WHITE PLAINS NY
10601-4429
US
IV. Provider business mailing address
34 S BROADWAY STE 504
WHITE PLAINS NY
10601-4429
US
V. Phone/Fax
- Phone: 914-454-2505
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ERIC
ROSS
Title or Position: OWNER
Credential: MD
Phone: 914-454-2505