Provider Demographics
NPI:1235268665
Name:MECHANIC, JEFF SIDNEY (JEFF MECHANIC)
Entity Type:Individual
Prefix:MR
First Name:JEFF
Middle Name:SIDNEY
Last Name:MECHANIC
Suffix:
Gender:M
Credentials:JEFF MECHANIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 W 72ND ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-2655
Mailing Address - Country:US
Mailing Address - Phone:212-501-0521
Mailing Address - Fax:
Practice Address - Street 1:305 W 72ND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-2655
Practice Address - Country:US
Practice Address - Phone:212-501-0521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR104963101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health