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General NPI Number Information
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NPI Number | 1740599570
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Entity Type | Organization
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Legal Business Name | NEW YORK STATE PSYCHIATRIC INSTITUTE
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Dates
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Enumeration Date | 09/28/2010
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Last Update Date | 09/28/2010
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Provider Practice Location Address
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Address Line | 504 W 136TH ST APT 6-C
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City | NEW YORK
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State | NY
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Zip | 10031-7908
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Country | US
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Telephone | 164-662-3779
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Fax |
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Provider Business Mailing Address
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Address Line | 504 W 136TH ST APT 6-C
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City | NEW YORK
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State | NY
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Zip | 10031-7908
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Country | US
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Telephone | 164-662-3779
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPY ASSISTANT
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Name | MR. HERIBERTO RIVERA
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Credential | CERTIFIED
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Telephone | 164-662-3779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | 006354-1
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License Number State | NY
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