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General NPI Number Information
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NPI Number | 1679628101
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Entity Type | Organization
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Legal Business Name | MIND SOLUTIONS PSYCHIATRY, P.C.
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 05/08/2009
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Provider Practice Location Address
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Address Line | 138 W 25TH ST 6TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10001-7405
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Country | US
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Telephone | 646-413-1825
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Fax |
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Provider Business Mailing Address
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Address Line | 270 BRONXVILLE RD #A53
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City | BRONXVILLE
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State | NY
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Zip | 10708-2848
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Country | US
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Telephone | 978-794-1919
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DEREK M TATE
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Credential | MD
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Telephone | 646-413-1825
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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