Provider Demographics
NPI:1003864729
Name:FACULTY PSYCHIATRIC ASSOCIATES, PC
Entity Type:Organization
Organization Name:FACULTY PSYCHIATRIC ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:SEMMELRATH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-493-8198
Mailing Address - Street 1:95 GRASSLANDS ROAD
Mailing Address - Street 2:NYMC BEHAVIORAL HEALTH CENTER ROOM N326
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595
Mailing Address - Country:US
Mailing Address - Phone:914-493-8198
Mailing Address - Fax:914-493-1015
Practice Address - Street 1:95 GRASSLANDS ROAD
Practice Address - Street 2:NYMC BEHAVIORAL HEALTH CENTER ROOM N326
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595
Practice Address - Country:US
Practice Address - Phone:914-493-8198
Practice Address - Fax:914-493-1015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00553526Medicaid
NYW06261Medicare PIN