Provider Demographics
NPI:1467581843
Name:EATING DISORDER RESOURCE CENTER
Entity Type:Organization
Organization Name:EATING DISORDER RESOURCE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:BRISMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:212-989-3987
Mailing Address - Street 1:330 W 58TH ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1827
Mailing Address - Country:US
Mailing Address - Phone:212-989-3987
Mailing Address - Fax:
Practice Address - Street 1:330 W 58TH ST
Practice Address - Street 2:SUITE 206
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1827
Practice Address - Country:US
Practice Address - Phone:212-989-3987
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Single Specialty