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General NPI Number Information
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NPI Number | 1295266302
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Entity Type | Organization
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Legal Business Name | STIM PSYCHIATRIC PLLC
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Dates
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Enumeration Date | 03/21/2017
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Last Update Date | 05/08/2017
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Provider Practice Location Address
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Address Line | 615 AVENUE L C/O NEUROCARE TMS
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City | BROOKLYN
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State | NY
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Zip | 11230-5121
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Country | US
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Telephone | 718-375-0755
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Fax |
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Provider Business Mailing Address
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Address Line | 615 AVENUE L ℅ NEUROCARE TMS
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City | BROOKLYN
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State | NY
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Zip | 11230-5121
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Country | US
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Telephone | 718-375-0755
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. LAWRENCE BRYSKIN
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Credential | MD
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Telephone | 718-375-0755
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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 | 100549
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License Number State | NY
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