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General NPI Number Information
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NPI Number | 1508262841
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Entity Type | Organization
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Legal Business Name | EMILY EYERMAN THERAPY
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Dates
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Enumeration Date | 11/14/2014
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Last Update Date | 11/14/2014
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Provider Practice Location Address
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Address Line | 271 MADISON AVE SUITE 1400
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City | NEW YORK
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State | NY
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Zip | 10016-1001
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Country | US
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Telephone | 347-878-5733
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Fax |
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Provider Business Mailing Address
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Address Line | 4540 CENTER BLVD APT 2409
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City | LONG ISLAND CITY
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State | NY
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Zip | 11109-5792
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Country | US
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Telephone | 516-655-8648
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | EMILY EYERMAN
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Credential | LMFT
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Telephone | 516-655-8648
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 001003
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License Number State | NY
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