MEDICARE: PSCH, INC.

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609029909
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PSCH, INC.

Provider Business Mailing Address
First Line	:	2244 119TH ST
Second Line	:
City	:	COLLEGE POINT
State	:	NY
Zip	:	11356-2516
Country	:	US
Telephone Number	:	718-445-4700
Fax Number	:	718-939-5440

Provider Business Practice Location Address
First Line	:	2244 119TH ST
Second Line	:
City	:	COLLEGE POINT
State	:	NY
Zip	:	11356-2516
Country	:	US
Telephone Number	:	718-445-4700
Fax Number	:	718-939-5440

Authorized Official
Title or Position	:	ACCT. REC. MANAGER
Name	:	MS. CAROL JOHNSON
Credential	:
Telephone Number	:	718-445-4700

Provider Enumeration Date	:	10/30/2008
Last Update Date	:	10/30/2008

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Directions to “PSCH, INC. ” Practice Location

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