Provider Demographics
NPI:1235434937
Name:INTEGRATIVE PSYCHIATRY OF NY, PC
Entity Type:Organization
Organization Name:INTEGRATIVE PSYCHIATRY OF NY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD, PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:STAMU-O'BRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-430-5684
Mailing Address - Street 1:99 MADISON AVE FL 5
Mailing Address - Street 2:SUITE 531
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-7419
Mailing Address - Country:US
Mailing Address - Phone:646-430-5684
Mailing Address - Fax:646-430-5631
Practice Address - Street 1:99 MADISON AVE FL 5
Practice Address - Street 2:SUITE 531
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-7419
Practice Address - Country:US
Practice Address - Phone:646-430-5684
Practice Address - Fax:646-430-5631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-11
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY215303261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health