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MEDICAL PRACTICE NY PC NPI 1437494648


NPI Information

NPI: 1437494648
Provider Name: MEDICAL PRACTICE NY PC
Classification: Psychologist - 103TP2701X
Entity Type: Organization

Specialization: Group Psychotherapy

Address:
6923 168TH ST
FRESH MEADOWS, NY
ZIP 11365
Phone: (718) 755-0656
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MEDICAL PRACTICE NY PC is a group psychotherapy psychologist in Fresh Meadows, NY. The provider is a psychologist who specializes in group psychology and group psychotherapy that is an evidenced-based specialty that prepares group leaders to identify and capitalize on developmental and healing possibilities embedded in the interpersonal/intrapersonal functioning of individual group members as well as collectively for the group. Emphasis is placed on the use of group dynamics to assist and treat individual group members. The specialty is applicable to all age groups, children, adolescents, adults and older adults, for a wide variety of conditions and concerns, and in numerous and diverse settings. MEDICAL PRACTICE NY PC NPI is 1437494648. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

6923 168TH ST
FRESH MEADOWS, NY
ZIP 11365-213
Phone: (718) 755-0656

The provider's authorized official is Yelena Mamedova Braz .
The authorized official title is Md and has the following contact phone number (718) 755-0656.

The enumeration date for this NPI number is 11/29/2012 and was last updated on 11/29/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103TP2701XPsychologistGroup Psychotherapy185185NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
101274024MEDICAIDNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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