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General NPI Number Information
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NPI Number | 1528292984
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Entity Type | Organization
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Legal Business Name | JAIME E INCLAN PHD P C
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Dates
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Enumeration Date | 05/13/2009
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Last Update Date | 05/13/2009
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Provider Practice Location Address
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Address Line | 85 5TH AVE SUITE 901
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City | NEW YORK
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State | NY
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Zip | 10003-3019
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Country | US
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Telephone | 212-741-3448
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Fax |
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Provider Business Mailing Address
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Address Line | 540 E 13TH ST ATTN: SHAWN EKWALL
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City | NEW YORK
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State | NY
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Zip | 10009-3519
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Country | US
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Telephone | 212-387-7400
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Fax | 212-387-7432
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Authorized Official
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Title or Position | ASSISTANT TO DR. INCLAN
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Name | MR. SHAWN EKWALL
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Credential |
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Telephone | 212-387-7433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 006997-1
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License Number State | NY
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