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General NPI Number Information
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NPI Number | 1609723543
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Entity Type | Organization
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Legal Business Name | MIND GROVE PSYCHOLOGY PLLC
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Dates
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Enumeration Date | 03/11/2026
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Last Update Date | 03/11/2026
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Provider Practice Location Address
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Address Line | 220 5TH AVE # 11TH
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City | NEW YORK
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State | NY
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Zip | 10001-7708
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Country | US
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Telephone | 339-223-4507
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Fax |
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Provider Business Mailing Address
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Address Line | 300 W 122ND ST APT 11C
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City | NEW YORK
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State | NY
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Zip | 10027-5376
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. HANSEUNG SIMON CHOI
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Credential |
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Telephone | 339-223-4507
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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