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General NPI Number Information
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NPI Number | 1750437968
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Entity Type | Organization
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Legal Business Name | PHYLLIS S ZILKHA PHD PSYCHOLOGIST PC
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Dates
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Enumeration Date | 01/28/2007
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Last Update Date | 03/19/2014
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Provider Practice Location Address
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Address Line | 301 E 79TH ST 23A
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City | NEW YORK
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State | NY
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Zip | 10075-0951
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Country | US
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Telephone | 212-988-7170
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Fax |
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Provider Business Mailing Address
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Address Line | 301 E 79TH ST 23A
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City | NEW YORK
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State | NY
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Zip | 10075-0951
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Country | US
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Telephone | 212-988-7170
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PHYLLIS S ZILKHA
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Credential | PH.D.
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Telephone | 212-988-7170
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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 | 011742
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License Number State | NY
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