| Wingspan Psychiatric, Llc | |
|
138 S Columbus Ave Fl 1 Mount Vernon NY 10553-1337 | |
| (914) 413-1553 | |
| (978) 701-6001 |
| Full Name | Wingspan Psychiatric, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 138 S Columbus Ave Fl 1, Mount Vernon, New York |
| Authorized Official Name and Position | Francis Hayden (OWNER) |
| Authorized Official Contact | 9144131553 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wingspan Psychiatric, Llc 101 Ellwood Ave Apt 4a Mount Vernon NY 10552-3428 Ph: (914) 413-1553 | Wingspan Psychiatric, Llc 138 S Columbus Ave Fl 1 Mount Vernon NY 10553-1337 Ph: (914) 413-1553 |
| NPI Number | 1093088502 |
|---|---|
| Provider Enumeration Date | 02/14/2012 |
| Last Update Date | 12/27/2020 |
| Certification Date | 12/27/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093088502 | NPI | - | NPPES |
| 01550791 | Medicaid | NY | |
| 03438319 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 189845 (New York) | Primary |
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