MEDICARE: MS. HOPE IGLEHEART LP

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	102L00000X	Psychoanalyst	000092	NY

General Provider Information

NPI Number	:	1801327168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. HOPE IGLEHEART LP

Provider Business Mailing Address
First Line	:	59 WOOSTER ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10012-4349
Country	:	US
Telephone Number	:	212-334-0263
Fax Number	:	212-925-2563

Provider Business Practice Location Address
First Line	:	59 WOOSTER ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10012-4349
Country	:	US
Telephone Number	:	212-334-0263
Fax Number	:	212-925-2563

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2017
Last Update Date	:	03/27/2017

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