Provider Demographics
NPI:1376956326
Name:PSYCHIATRIC NP THERAPEUTICS, PLLC
Entity Type:Organization
Organization Name:PSYCHIATRIC NP THERAPEUTICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGRAW
Authorized Official - Suffix:
Authorized Official - Credentials:NP-P
Authorized Official - Phone:914-636-3535
Mailing Address - Street 1:481 MAIN ST
Mailing Address - Street 2:SUITE 303A
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-6324
Mailing Address - Country:US
Mailing Address - Phone:914-636-3535
Mailing Address - Fax:914-636-3536
Practice Address - Street 1:481 MAIN ST
Practice Address - Street 2:SUITE 303A
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-6324
Practice Address - Country:US
Practice Address - Phone:914-636-3535
Practice Address - Fax:914-636-3536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-07
Last Update Date:2014-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY401228261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health