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General NPI Number Information
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NPI Number | 1215325261
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Entity Type | Organization
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Legal Business Name | PEACEFUL WAY PSYCHOLOGY PLLC
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Dates
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Enumeration Date | 12/29/2014
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Last Update Date | 11/28/2023
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Provider Practice Location Address
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Address Line | 260 MADISON AVE SUITE 8006
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City | NEW YORK
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State | NY
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Zip | 10016-2400
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Country | US
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Telephone | 212-335-0522
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Fax | 646-494-0410
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Provider Business Mailing Address
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Address Line | 260 MADISON AVE SUITE 8006
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City | NEW YORK
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State | NY
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Zip | 10016-2400
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Country | US
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Telephone | 212-335-0522
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Fax | 646-494-0410
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHRISTINE FERNANDEZ
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Credential | PH.D.
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Telephone | 212-335-0511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 016691
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License Number State | NY
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