| Service Program For Older People Inc | |
|
302 W 91st St New York NY 10024-1011 | |
| (212) 787-7120 | |
| Not Available |
| Full Name | Service Program For Older People Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 302 W 91st St, New York, New York |
| Authorized Official Name and Position | Nancy Harvey (EXEC DIRECTOR) |
| Authorized Official Contact | 2127877120 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Service Program For Older People Inc 302 W 91st St 2nd Flr New York NY 10024-1011 Ph: (212) 787-7120 | Service Program For Older People Inc 302 W 91st St New York NY 10024-1011 Ph: (212) 787-7120 |
| NPI Number | 1740211143 |
|---|---|
| Provider Enumeration Date | 07/05/2006 |
| Last Update Date | 05/19/2014 |
| Medicare PECOS PAC ID | 2668373135 |
|---|---|
| Medicare Enrollment ID | O20040116000978 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740211143 | NPI | - | NPPES |
| A2391634 | Other | NY | OXFORD |
| 00245327 | Medicaid | NY | |
| 313087 | Other | NY | VALUE OPTIONS |
| 00813034 | Medicaid | NY | |
| 7480603 | Other | NY | GHI |
| 26178P | Other | NY | HIP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0805X | Psychiatry & Neurology - Geriatric Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Barbara Rothbart |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265596456 PECOS PAC ID: 0345234746 Enrollment ID: I20040408001599 |
| Provider Name | Wayne Carrion |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659466670 PECOS PAC ID: 4284725664 Enrollment ID: I20070822000453 |
| Provider Name | Sharon E Kettrles |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710188651 PECOS PAC ID: 0648369751 Enrollment ID: I20071127000568 |
| Provider Name | Anet Ruperto |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306005939 PECOS PAC ID: 5991870859 Enrollment ID: I20080812000871 |
| Provider Name | Mitchell P Butin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891771374 PECOS PAC ID: 5799860698 Enrollment ID: I20090113000416 |
| Provider Name | Sandra C Agredo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003957929 PECOS PAC ID: 0547307258 Enrollment ID: I20091029000483 |
| Provider Name | Martine J Baron |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962639039 PECOS PAC ID: 0648394361 Enrollment ID: I20100902000414 |
| Provider Name | Maria C Mocellin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831379981 PECOS PAC ID: 1153446380 Enrollment ID: I20100913000160 |
| Provider Name | Andrew H Beecher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790826691 PECOS PAC ID: 5597946251 Enrollment ID: I20110301000352 |
| Provider Name | Lauren Taylor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649397365 PECOS PAC ID: 6709067473 Enrollment ID: I20110301000427 |
| Provider Name | Doris Urrea |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902990526 PECOS PAC ID: 1759556723 Enrollment ID: I20111203000020 |
| Provider Name | Eeva J Mikkola |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528220712 PECOS PAC ID: 2860629326 Enrollment ID: I20131209001335 |
| Provider Name | Nydawattie Nanjad |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457746257 PECOS PAC ID: 5092025981 Enrollment ID: I20151104002877 |
| Provider Name | Wendy Golub |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710393855 PECOS PAC ID: 3870893308 Enrollment ID: I20151204001411 |
| Provider Name | Amelia Paris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083772206 PECOS PAC ID: 7113226887 Enrollment ID: I20160502000685 |
| Provider Name | Alexandra Webb |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497081673 PECOS PAC ID: 0042505778 Enrollment ID: I20160819001557 |
| Provider Name | Abigail B Strubel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568792158 PECOS PAC ID: 8820363781 Enrollment ID: I20171004000177 |
| Provider Name | Philip H Paul |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548754708 PECOS PAC ID: 3173870904 Enrollment ID: I20180724003527 |
| Provider Name | Evelyn Kuang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588188700 PECOS PAC ID: 2466709092 Enrollment ID: I20180727000318 |
| Provider Name | Marc J Raybin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487076949 PECOS PAC ID: 9739430349 Enrollment ID: I20180920002294 |
| Provider Name | Arianne D Halliday |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174063135 PECOS PAC ID: 6507101631 Enrollment ID: I20181218003185 |
| Provider Name | Bruce Adam Birnberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124500244 PECOS PAC ID: 3779623426 Enrollment ID: I20190514002024 |
| Provider Name | Teresa M Theophano |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427608629 PECOS PAC ID: 8628309234 Enrollment ID: I20191014000912 |
| Provider Name | Sarah W Mcconkey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295283786 PECOS PAC ID: 2466862628 Enrollment ID: I20201029002557 |
| Provider Name | Charlotte E Coates |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346802865 PECOS PAC ID: 4082024807 Enrollment ID: I20201106001489 |
| Provider Name | Kathleen V Harris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932592177 PECOS PAC ID: 4183032824 Enrollment ID: I20210420000259 |
| Provider Name | Ewelina Turlik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598548034 PECOS PAC ID: 0042661290 Enrollment ID: I20240111003890 |
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