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General NPI Number Information
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NPI Number | 1457619496
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Entity Type | Organization
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Legal Business Name | NEW YORK ANXIETY TREATMENT CENTER
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Dates
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Enumeration Date | 04/27/2012
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Last Update Date | 04/27/2012
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Provider Practice Location Address
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Address Line | 210 E 68TH ST STE 1B
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City | NEW YORK
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State | NY
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Zip | 10065-6024
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Country | US
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Telephone | 212-518-8162
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Fax |
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Provider Business Mailing Address
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Address Line | 25 W 68TH ST APT 1D
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City | NEW YORK
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State | NY
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Zip | 10023-5302
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. ANNA R. EDWARDS
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Credential | PH.D.
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Telephone | 212-581-8162
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | 019403
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License Number State | NY
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