Provider Demographics
NPI:1477132165
Name:PARK PSYCHOLOGICAL SERVICES, P.C.
Entity Type:Organization
Organization Name:PARK PSYCHOLOGICAL SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:EGER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:646-322-9787
Mailing Address - Street 1:108 E 91ST ST APT 1B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1659
Mailing Address - Country:US
Mailing Address - Phone:646-322-9787
Mailing Address - Fax:
Practice Address - Street 1:108 E 91ST ST APT 1B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1659
Practice Address - Country:US
Practice Address - Phone:646-322-9787
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-07
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty