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General NPI Number Information
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NPI Number | 1508286873
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Entity Type | Organization
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Legal Business Name | MANHATTAN PSYCHIATRIC ASSOCIATES, PLLC
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Dates
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Enumeration Date | 04/24/2014
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Last Update Date | 07/23/2014
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Provider Practice Location Address
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Address Line | 57 W 57TH ST STE 912
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City | NEW YORK
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State | NY
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Zip | 10019-2829
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Country | US
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Telephone | 855-767-7287
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Fax | 646-687-7893
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Provider Business Mailing Address
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Address Line | 57 W 57TH ST STE 912
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City | NEW YORK
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State | NY
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Zip | 10019-2829
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Country | US
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Telephone | 855-767-7287
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Fax | 646-687-7893
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. MICHAEL GOLDER
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Credential | MD
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Telephone | 855-767-7287
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 019998
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 017410
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 254324
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 268082
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License Number State | NY
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