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General NPI Number Information
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NPI Number | 1366869430
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Entity Type | Organization
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Legal Business Name | LM PSYCHIATRIC SERVICES
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Dates
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Enumeration Date | 03/26/2014
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Last Update Date | 03/26/2014
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Provider Practice Location Address
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Address Line | 310 W 72ND ST STE 1F
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City | NEW YORK
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State | NY
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Zip | 10023-2675
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Country | US
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Telephone | 212-362-0609
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Fax | 212-362-0704
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Provider Business Mailing Address
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Address Line | 310 W 72ND ST STE 1F
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City | NEW YORK
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State | NY
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Zip | 10023-2675
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Country | US
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Telephone | 212-362-0609
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Fax | 212-362-0704
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Authorized Official
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Title or Position | OWNER
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Name | DR. LAURIE BETH MECKLER
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Credential | M.D.
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Telephone | 212-362-0609
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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 | 190602
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License Number State | NY
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