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General NPI Number Information
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NPI Number | 1699199869
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Entity Type | Organization
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Legal Business Name | SUNRISE PSYCHOLOGICAL SERVICES LLC
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Dates
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Enumeration Date | 02/09/2014
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Last Update Date | 02/09/2014
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Provider Practice Location Address
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Address Line | 25 ROYAL CREST DR
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City | PROSPECT
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State | CT
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Zip | 06712-1486
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Country | US
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Telephone | 845-826-0060
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1250
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City | MONSEY
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State | NY
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Zip | 10952-8349
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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 | PRESIDENT
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Name | JOEL MEISELS
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Credential |
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Telephone | 845-826-0060
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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 |
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License Number State |
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