Provider Demographics
NPI:1346519220
Name:SUNLIGHT MEDICAL AND PSYCHIATRIC SERVICES P.C
Entity Type:Organization
Organization Name:SUNLIGHT MEDICAL AND PSYCHIATRIC SERVICES P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EWALD
Authorized Official - Middle Name:JONATHAN
Authorized Official - Last Name:ANTOINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-462-9170
Mailing Address - Street 1:2769 CONEY ISLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-5061
Mailing Address - Country:US
Mailing Address - Phone:347-462-9170
Mailing Address - Fax:
Practice Address - Street 1:3057 CONEY ISLAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-6320
Practice Address - Country:US
Practice Address - Phone:347-462-9170
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty