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General NPI Number Information
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NPI Number | 1053713370
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Entity Type | Organization
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Legal Business Name | LANA GAITON PSYCHOLOGICAL SERVICES
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Dates
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Enumeration Date | 09/17/2014
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Last Update Date | 09/17/2014
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Provider Practice Location Address
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Address Line | 225 BROADWAY SUITE 3400
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City | NEW YORK
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State | NY
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Zip | 10007-3001
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Country | US
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Telephone | 347-613-2708
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Fax |
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Provider Business Mailing Address
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Address Line | 2 CHARLTON ST #11H
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City | NEW YORK
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State | NY
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Zip | 10014-4909
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Country | US
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Telephone | 347-613-2708
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. LANA GAITON
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Credential | PH.D.
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Telephone | 347-613-2708
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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 | 73 073064
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 016868
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License Number State | NY
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