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General NPI Number Information
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NPI Number | 1881973667
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Entity Type | Organization
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Legal Business Name | THE SOCIAL THERAPY GROUP
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Dates
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Enumeration Date | 08/10/2011
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Last Update Date | 12/04/2012
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Provider Practice Location Address
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Address Line | 106 S OXFORD ST
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City | BROOKLYN
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State | NY
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Zip | 11217-1608
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Country | US
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Telephone | 718-797-3220
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Fax |
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Provider Business Mailing Address
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Address Line | 106 S OXFORD ST
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City | BROOKLYN
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State | NY
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Zip | 11217-1608
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Country | US
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Telephone | 718-797-3220
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Fax |
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Authorized Official
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Title or Position | ASSISTANT DIRECTOR
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Name | DR. HUGH POLK
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Credential | M.D.
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Telephone | 718-797-3220
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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