| Wingspan Psychiatric, Llc | |
|
138 S Columbus Ave Fl 1 Mount Vernon NY 10553-1337 | |
| (718) 701-3285 | |
| (978) 701-6001 |
| Full Name | Wingspan Psychiatric, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 138 S Columbus Ave Fl 1, Mount Vernon, New York |
| Authorized Official Name and Position | Francis F Hayden (SOLE OWNER) |
| Authorized Official Contact | 9144131553 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| 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: (718) 701-3285 |
| NPI Number | 1891067294 |
|---|---|
| Provider Enumeration Date | 01/31/2012 |
| Last Update Date | 12/27/2020 |
| Certification Date | 12/27/2020 |
| Medicare PECOS PAC ID | 6507020450 |
|---|---|
| Medicare Enrollment ID | O20120606000095 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891067294 | NPI | - | NPPES |
| 01550792 | Medicaid | NY | |
| 03438319 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 189845 (New York) | Primary |
| Provider Name | Francis F Hayden |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346334653 PECOS PAC ID: 1254437007 Enrollment ID: I20070510000623 |
| Provider Name | Ruth Mary Warwick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326264946 PECOS PAC ID: 8527256197 Enrollment ID: I20101223000199 |
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