| Nyc Psychological Services, Pllc | |
|
105 Lexington Ave Apt 10a 27f New York NY 10016-8964 | |
| (212) 602-1722 | |
| Not Available |
| Full Name | Nyc Psychological Services, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 105 Lexington Ave Apt 10a, New York, New York |
| Authorized Official Name and Position | Michael Ivanov (DIRECTOR) |
| Authorized Official Contact | 2126021722 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nyc Psychological Services, Pllc 105 Lexington Ave Apt 10a 27f New York NY 10016-8964 Ph: (212) 602-1722 | Nyc Psychological Services, Pllc 105 Lexington Ave Apt 10a 27f New York NY 10016-8964 Ph: (212) 602-1722 |
| NPI Number | 1124431002 |
|---|---|
| Provider Enumeration Date | 06/09/2014 |
| Last Update Date | 03/04/2017 |
| Medicare PECOS PAC ID | 7517188956 |
|---|---|
| Medicare Enrollment ID | O20141028001008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124431002 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 020355 (New York) | Primary |
| Provider Name | Michael Ivanov |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1639234313 PECOS PAC ID: 5597986935 Enrollment ID: I20141028001229 |
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