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9027 Sutphin Blvd Jamaica NY 11435-3631 | |
| (718) 526-8400 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychologist - Counseling |
| Location | 9027 Sutphin Blvd, Jamaica, New York |
| Authorized Official Name and Position | Stan Corfman (CFO) |
| Authorized Official Contact | 7187466647 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1016 162nd St Whitestone NY 11357-2124 Ph: (718) 746-6647 | 9027 Sutphin Blvd Jamaica NY 11435-3631 Ph: (718) 526-8400 |
| NPI Number | 1780855213 |
|---|---|
| Provider Enumeration Date | 03/12/2008 |
| Last Update Date | 10/17/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780855213 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | (* (Not Available)) | Primary |
| 103TR0400X | Psychologist - Rehabilitation | (* (Not Available)) | Secondary |
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