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General NPI Number Information
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NPI Number | 1396783049
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Entity Type | Organization
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Legal Business Name | ST. MARK'S PLACE INSTITUTE FOR MENTAL HEALTH, INC
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 11/02/2016
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Provider Practice Location Address
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Address Line | 57 SAINT MARKS PL
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City | NEW YORK
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State | NY
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Zip | 10003-7902
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Country | US
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Telephone | 212-982-3470
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Fax | 212-477-0521
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Provider Business Mailing Address
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Address Line | 57 SAINT MARKS PL
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City | NEW YORK
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State | NY
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Zip | 10003-7902
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Country | US
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Telephone | 212-982-3470
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Fax | 212-477-0521
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ROMAN PABIS
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Credential | PHD
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Telephone | 212-982-3470
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 7574100A
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License Number State | NY
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