Provider Demographics
NPI:1033512215
Name:OPTIMAL LIVING PSYCHOLOGICAL SERVICES, PC
Entity Type:Organization
Organization Name:OPTIMAL LIVING PSYCHOLOGICAL SERVICES, PC
Other - Org Name:CENTER FOR OPTIMAL LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:TATARSKY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:212-213-8905
Mailing Address - Street 1:370 LEXINGTON AVE, SUITE #500
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017
Mailing Address - Country:US
Mailing Address - Phone:212-213-8905
Mailing Address - Fax:212-213-8905
Practice Address - Street 1:370 LEXINGTON AVE, SUITE #500
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017
Practice Address - Country:US
Practice Address - Phone:212-213-8905
Practice Address - Fax:212-213-8905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-02
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty