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General NPI Number Information
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NPI Number | 1528567005
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Entity Type | Organization
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Legal Business Name | VM PSYCHOLOGICAL SERVICES, INC
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Dates
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Enumeration Date | 02/09/2018
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Last Update Date | 02/09/2018
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Provider Practice Location Address
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Address Line | 330 W 58TH ST STE 409
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City | NEW YORK
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State | NY
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Zip | 10019-1820
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Country | US
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Telephone | 212-221-4567
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Fax |
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Provider Business Mailing Address
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Address Line | 330 W 58TH ST STE 409
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City | NEW YORK
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State | NY
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Zip | 10019-1820
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Country | US
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Telephone | 212-221-4567
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | VAIA TSOLAS
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Credential | PHD
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Telephone | 212-221-4567
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TP0814X
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Taxonomy Name | Psychoanalysis Psychologist
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License Number | 0106893-1
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License Number State | NY
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