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1124 Route 94 Ste 201 New Windsor NY 12553 | |
| (845) 458-4557 | |
| (845) 458-4559 |
| Full Name | |
|---|---|
| Speciality | Psychologist |
| Location | 1124 Route 94, New Windsor, New York |
| Authorized Official Name and Position | Barry J. Shrem (DIRECTOR) |
| Authorized Official Contact | 8454584557 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1124 Route 94 Ste 201 New Windsor NY 12553 Ph: (845) 458-4557 | 1124 Route 94 Ste 201 New Windsor NY 12553 Ph: (845) 458-4557 |
| NPI Number | 1528349024 |
|---|---|
| Provider Enumeration Date | 08/29/2011 |
| Last Update Date | 03/14/2016 |
| Medicare PECOS PAC ID | 5294072211 |
|---|---|
| Medicare Enrollment ID | O20190130000253 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528349024 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 014925-01 (New York) | Primary |
| Provider Name | Farrell Eisenberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093885790 PECOS PAC ID: 2264405281 Enrollment ID: I20040818000165 |
| Provider Name | Gifty G Ampadu |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184103970 PECOS PAC ID: 8325385255 Enrollment ID: I20190130000947 |
| Provider Name | Angelina M Patton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235857350 PECOS PAC ID: 4183082852 Enrollment ID: I20230628001575 |
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