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General NPI Number Information
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NPI Number | 1235434937
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE PSYCHIATRY OF NY, PC
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Dates
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Enumeration Date | 01/11/2011
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Last Update Date | 02/28/2012
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Provider Practice Location Address
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Address Line | 99 MADISON AVE FL 5 SUITE 531
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City | NEW YORK
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State | NY
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Zip | 10016-7419
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Country | US
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Telephone | 646-430-5684
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Fax | 646-430-5631
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Provider Business Mailing Address
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Address Line | 99 MADISON AVE FL 5 SUITE 531
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City | NEW YORK
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State | NY
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Zip | 10016-7419
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Country | US
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Telephone | 646-430-5684
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Fax | 646-430-5631
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Authorized Official
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Title or Position | MD, PRESIDENT
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Name | DR. CAROLINE STAMU-O'BRIEN
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Credential | M.D.
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Telephone | 646-430-5684
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 215303
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License Number State | NY
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