| Psor | |
|
20 West Ave Suite 103 Chester NY 10918-1032 | |
| (845) 469-3621 | |
| (845) 469-3618 |
| Full Name | Psor |
|---|---|
| Speciality | Behavior Analyst |
| Location | 20 West Ave, Chester, New York |
| Authorized Official Name and Position | Linden Jeffrey Schild (OWNER) |
| Authorized Official Contact | 8454693621 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psor 20 West Ave Suite 103 Chester NY 10918-1032 Ph: (845) 469-3621 | Psor 20 West Ave Suite 103 Chester NY 10918-1032 Ph: (845) 469-3621 |
| NPI Number | 1578837290 |
|---|---|
| Provider Enumeration Date | 02/27/2012 |
| Last Update Date | 02/27/2012 |
| Medicare PECOS PAC ID | 2466610043 |
|---|---|
| Medicare Enrollment ID | O20120229000128 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578837290 | NPI | - | NPPES |
| 01389931 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | 191640 (New York) | Primary |
| Provider Name | Linden J Schild |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831156710 PECOS PAC ID: 0345408928 Enrollment ID: I20120229000165 |
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