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General NPI Number Information
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NPI Number | 1003327552
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Entity Type | Organization
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Legal Business Name | MID CITY TMS PSYCHIATRIC PLLC
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Dates
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Enumeration Date | 10/23/2017
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Last Update Date | 10/23/2017
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Provider Practice Location Address
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Address Line | 280 MADISON AVE RM 1102
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City | NEW YORK
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State | NY
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Zip | 10016-0817
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Country | US
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Telephone | 212-717-4869
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Fax |
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Provider Business Mailing Address
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Address Line | 280 MADISON AVENUE ROOM 1102
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City | NEW YORK
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State | NY
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Zip | 10016-0801
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Country | US
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Telephone | 212-717-4869
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | EMILY SEESE
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Credential |
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Telephone | 212-717-4869
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 203615
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License Number State | NY
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