| Dr. Tulsa Knox Psychologial Services, Pllc | |
|
25 8th Ave Ste B Brooklyn NY 11217-3755 | |
| (845) 702-8764 | |
| Not Available |
| Full Name | Dr. Tulsa Knox Psychologial Services, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 25 8th Ave Ste B, Brooklyn, New York |
| Authorized Official Name and Position | Tulsa Knox (OWNER) |
| Authorized Official Contact | 8457028764 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Tulsa Knox Psychologial Services, Pllc 124 Ritch Ave W Apt A303 Greenwich CT 06830-6965 Ph: (845) 702-8764 | Dr. Tulsa Knox Psychologial Services, Pllc 25 8th Ave Ste B Brooklyn NY 11217-3755 Ph: (845) 702-8764 |
| NPI Number | 1356072698 |
|---|---|
| Provider Enumeration Date | 06/17/2022 |
| Last Update Date | 06/17/2022 |
| Certification Date | 06/17/2022 |
| Medicare PECOS PAC ID | 9537540521 |
|---|---|
| Medicare Enrollment ID | O20220722000105 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356072698 | NPI | - | NPPES |
| 003748 | Other | CT | STATE OF CT |
| 021220 | Other | NY | NY STATE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Tulsa Knox |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508241092 PECOS PAC ID: 4688983315 Enrollment ID: I20151021000259 |
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