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General NPI Number Information
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NPI Number | 1801953450
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Entity Type | Organization
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Legal Business Name | HEARTLAND PSYCHOLOGICAL SERVICES PC
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 12/02/2013
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Provider Practice Location Address
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Address Line | 251 RICHMOND HILL RD HEARTLAND PSYCHOLOGICAL SERVICES P.C.
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City | STATEN ISLAND
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State | NY
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Zip | 10314-5906
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Country | US
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Telephone | 718-494-9397
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Fax | 718-761-1000
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Provider Business Mailing Address
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Address Line | PO BOX 141280 HEARTLAND PSYCHOLOGICAL SERVICES PC
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City | STATEN ISLAND
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State | NY
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Zip | 10314-1280
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Country | US
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Telephone | 718-494-9397
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Fax | 718-761-1000
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Authorized Official
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Title or Position | BILLING SEEY
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Name | MS. CYNTHIA R BOONE MASON
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Credential |
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Telephone | 718-494-9397
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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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