| Empire State Psychiatric Medicine Pllc | |
|
315 Madison Ave Rm 2000 New York NY 10017-5416 | |
| (646) 661-5225 | |
| Not Available |
| Full Name | Empire State Psychiatric Medicine Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 315 Madison Ave Rm 2000, New York, New York |
| Authorized Official Name and Position | Frank Perkins (PARTNER) |
| Authorized Official Contact | 2566560145 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Empire State Psychiatric Medicine Pllc Po Box 2786 Ridgeland MS 39158-2786 Ph: (256) 656-0145 | Empire State Psychiatric Medicine Pllc 315 Madison Ave Rm 2000 New York NY 10017-5416 Ph: (646) 661-5225 |
| NPI Number | 1245087261 |
|---|---|
| Provider Enumeration Date | 05/06/2024 |
| Last Update Date | 05/09/2024 |
| Certification Date | 05/09/2024 |
| Medicare PECOS PAC ID | 0840721825 |
|---|---|
| Medicare Enrollment ID | O20241001003131 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245087261 | NPI | - | NPPES |
| Provider Name | James S. Demer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891779849 PECOS PAC ID: 0042318578 Enrollment ID: I20070607000276 |
| Provider Name | Ilya Bernstein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982157236 PECOS PAC ID: 1254608649 Enrollment ID: I20170607000501 |
| Provider Name | Amanda Botros |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437995560 PECOS PAC ID: 5890229488 Enrollment ID: I20241105000857 |
| Provider Name | Shane Daniel Gallagher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124541446 PECOS PAC ID: 9830620913 Enrollment ID: I20241108002251 |
| Provider Name | Joseph Louis Spitalieri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124704598 PECOS PAC ID: 4082148861 Enrollment ID: I20241115002661 |
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