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General NPI Number Information
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NPI Number | 1841797420
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Entity Type | Organization
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Legal Business Name | SUSAN F EPSTEIN PHD, LICENSED PSYCHOLOGIST PLLC
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Dates
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Enumeration Date | 04/10/2018
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Last Update Date | 04/10/2018
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Provider Practice Location Address
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Address Line | 5 W 86TH ST APT 1C
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City | NEW YORK
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State | NY
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Zip | 10024-3663
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Country | US
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Telephone | 646-450-3633
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Fax |
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Provider Business Mailing Address
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Address Line | 3524 78TH ST APT B11
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-4705
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Country | US
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Telephone | 646-250-8441
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SUSAN F EPSTEIN
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Credential | PHD
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Telephone | 646-450-3633
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number | 016655
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 016655
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 016655
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License Number State | NY
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