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600 3rd Ave Fl 2 New York NY 10016-1919 | |
| (212) 547-8861 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 600 3rd Ave Fl 2, New York, New York |
| Authorized Official Name and Position | Aleander Alvarado (OWNER) |
| Authorized Official Contact | 6467180025 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
600 3rd Ave Fl 2 New York NY 10016-1919 Ph: (646) 718-0025 | 600 3rd Ave Fl 2 New York NY 10016-1919 Ph: (212) 547-8861 |
| NPI Number | 1932975919 |
|---|---|
| Provider Enumeration Date | 11/30/2023 |
| Last Update Date | 08/19/2024 |
| Certification Date | 08/19/2024 |
| Medicare PECOS PAC ID | 2860927241 |
|---|---|
| Medicare Enrollment ID | O20241121003012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932975919 | NPI | - | NPPES |
| Provider Name | Alexandra Catherine Tesnakis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841864386 PECOS PAC ID: 6709237290 Enrollment ID: I20240109003232 |
| Provider Name | Anissa Tara Anna House-grasley |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1174039176 PECOS PAC ID: 6709319932 Enrollment ID: I20241028000704 |
| Provider Name | Michaela Kauffmann |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1487763413 PECOS PAC ID: 4284640855 Enrollment ID: I20241121003981 |
| Provider Name | Mark Aghakhan |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1295843381 PECOS PAC ID: 7517277619 Enrollment ID: I20241122002234 |
| Provider Name | Amanda K Domo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750966313 PECOS PAC ID: 6305372095 Enrollment ID: I20241204003497 |
| Provider Name | Jenna Steinmiller Cappello |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1194430769 PECOS PAC ID: 0143756882 Enrollment ID: I20241205000924 |
| Provider Name | Alexis Grevers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205457215 PECOS PAC ID: 0244766905 Enrollment ID: I20241205001416 |
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