Provider Demographics
NPI:1063834273
Name:ROCKLAND PSYCHIATRIC CENTER
Entity Type:Organization
Organization Name:ROCKLAND PSYCHIATRIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXCECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:TAVELLA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:845-359-1000
Mailing Address - Street 1:7 VILLA DR
Mailing Address - Street 2:
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566-4900
Mailing Address - Country:US
Mailing Address - Phone:914-739-2737
Mailing Address - Fax:
Practice Address - Street 1:1040 MAIN ST
Practice Address - Street 2:
Practice Address - City:PEEKSKILL
Practice Address - State:NY
Practice Address - Zip Code:10566-2906
Practice Address - Country:US
Practice Address - Phone:914-737-8217
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-08
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5051441-1283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital