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General NPI Number Information
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NPI Number | 1821241738
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Entity Type | Organization
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Legal Business Name | METRO PSYCHIATRY PC
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Dates
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Enumeration Date | 10/23/2008
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Last Update Date | 10/23/2008
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Provider Practice Location Address
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Address Line | 276 5TH AVE SUITE 1101
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City | NEW YORK
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State | NY
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Zip | 10001-4509
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Country | US
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Telephone | 347-452-3485
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Fax |
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Provider Business Mailing Address
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Address Line | 300 E 71ST ST 16H
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City | NEW YORK
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State | NY
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Zip | 10021-5234
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Country | US
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Telephone | 212-249-4777
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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. MICHELLE WIDLITZ
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Credential | MD
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Telephone | 347-452-3485
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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 | 218963
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License Number State | NY
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