| Emorys Annex | |
|
7523 168th St Fresh Meadows NY 11366-1331 | |
| (917) 601-9029 | |
| Not Available |
| Full Name | Emorys Annex |
|---|---|
| Speciality | Psychologist - Counseling |
| Location | 7523 168th St, Fresh Meadows, New York |
| Authorized Official Name and Position | Mary Beth Sivak (CEO) |
| Authorized Official Contact | 9176019029 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Emorys Annex 7523 168th St Fresh Meadows NY 11366-1331 Ph: () - | Emorys Annex 7523 168th St Fresh Meadows NY 11366-1331 Ph: (917) 601-9029 |
| NPI Number | 1114709771 |
|---|---|
| Provider Enumeration Date | 10/18/2023 |
| Last Update Date | 10/18/2023 |
| Certification Date | 10/18/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114709771 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | (* (Not Available)) | Primary |
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