MEDICARE: OASIS PSYCHOLOGICAL SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	014362	NY

General Provider Information

NPI Number	:	1083857874
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OASIS PSYCHOLOGICAL SERVICES

Provider Business Mailing Address
First Line	:	1 RIVER PLACE
Second Line	:	#3801
City	:	NEW YORK
State	:	NY
Zip	:	10036-6008
Country	:	US
Telephone Number	:	917-406-8157
Fax Number	:

Provider Business Practice Location Address
First Line	:	1115 BROADWAY
Second Line	:	12TH FLOOR
City	:	NEW YORK
State	:	NY
Zip	:	10010-3450
Country	:	US
Telephone Number	:	917-406-8157
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL PSYCHOLOGIST
Name	:	DR. PAULETTE DEJOIE MURPHY
Credential	:	PSY.D.
Telephone Number	:	917-406-8157

Provider Enumeration Date	:	04/09/2009
Last Update Date	:	09/23/2009

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