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General NPI Number Information
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NPI Number | 1043248776
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Entity Type | Organization
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Legal Business Name | KNAPP STREET PSYCHIATRY, PC
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Dates
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Enumeration Date | 06/29/2006
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 2433 KNAPP ST STE 306
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City | BROOKLYN
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State | NY
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Zip | 11235-1005
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Country | US
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Telephone | 888-515-3834
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Fax | 855-688-6746
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Provider Business Mailing Address
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Address Line | PO BOX 68048
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City | NEWARK
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State | NJ
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Zip | 07101-8085
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Country | US
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Telephone | 888-515-3834
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LARRY DURLOFSKY
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Credential | DO
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Telephone | 888-515-3834
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 013758
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License Number State | NY
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