=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083857874
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | OASIS PSYCHOLOGICAL SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/09/2009
-----------------------------------------------------
Last Update Date | 09/23/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1115 BROADWAY 12TH FLOOR
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10010-3450
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-406-8157
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1 RIVER PLACE #3801
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10036-6008
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-406-8157
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CLINICAL PSYCHOLOGIST
-----------------------------------------------------
Name | DR. PAULETTE DEJOIE MURPHY
-----------------------------------------------------
Credential | PSY.D.
-----------------------------------------------------
Telephone | 917-406-8157
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number | 014362
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------