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General NPI Number Information
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NPI Number | 1124137971
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Entity Type | Organization
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Legal Business Name | PSYCHOLOGICAL STRESS MANAGEMENT SERVICES PC
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 280 MADISON AVE RM 1403
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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 | 917-566-3840
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Fax |
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Provider Business Mailing Address
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Address Line | 280 MADISON AVE RM 1403
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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 | 917-566-3840
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/DIRECTOR
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Name | DANIEL N GUERRA
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Credential | PSYD
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Telephone | 917-566-3840
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 014289
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License Number State | NY
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