MEDICARE: PROFESSIONAL THERAPEUTIC ASSOCIATES

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	103T00000X	Psychologist

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	:	1922020593
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROFESSIONAL THERAPEUTIC ASSOCIATES

Provider Business Mailing Address
First Line	:	250 ROUND HILL RD
Second Line	:
City	:	ROSLYN HEIGHTS
State	:	NY
Zip	:	11577-1537
Country	:	US
Telephone Number	:	516-625-4446
Fax Number	:

Provider Business Practice Location Address
First Line	:	250 ROUND HILL RD
Second Line	:
City	:	ROSLYN HEIGHTS
State	:	NY
Zip	:	11577-1537
Country	:	US
Telephone Number	:	516-625-4446
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOLOGIST
Name	:	BERNARD SORSCHER
Credential	:
Telephone Number	:	516-625-4446

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	12/27/2007

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Directions to “PROFESSIONAL THERAPEUTIC ASSOCIATES ” Practice Location

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