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General NPI Number Information
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NPI Number | 1275348823
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Entity Type | Organization
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Legal Business Name | VILLAGE GROUP MEDICAL PC
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Dates
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Enumeration Date | 02/11/2025
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | 80 5TH AVE RM 1405
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City | NEW YORK
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State | NY
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Zip | 10011-8002
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Country | US
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Telephone | 646-817-2835
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Fax | 646-817-2864
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Provider Business Mailing Address
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Address Line | 80 5TH AVE RM 1405
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City | NEW YORK
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State | NY
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Zip | 10011-8002
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Country | US
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Telephone | 646-817-2835
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Fax | 646-817-2864
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Authorized Official
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Title or Position | ADMINISTRATIVE
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Name | MS. BETH EGYED
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Credential |
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Telephone | 973-390-1748
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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