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General NPI Number Information
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NPI Number | 1548297997
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Entity Type | Organization
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Legal Business Name | NEW YORK PSYCHOLOGICAL AND BEHAVIORAL SERVICES
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Dates
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Enumeration Date | 06/28/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2306 NOSTRAND AVENUE BETWEEN AVE I AND J
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City | BROOKLYN
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State | NY
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Zip | 11210
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Country | US
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Telephone | 718-951-0236
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Fax | 718-951-0238
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Provider Business Mailing Address
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Address Line | 585 SCHENECTADY AVE NYPBS/SLEEP
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City | BROOKLYN
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State | NY
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Zip | 11203
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Country | US
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Telephone | 718-951-0236
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Fax | 718-951-0238
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | GIRARDIN JEAN-LOUIS
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Credential | PH.D.
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Telephone | 718-951-0236
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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 | 015542
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License Number State | NY
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