Provider Demographics
NPI:1477895738
Name:DR JOY CANFIELD PSYCHOLOGY PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:DR JOY CANFIELD PSYCHOLOGY PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOY
Authorized Official - Middle Name:
Authorized Official - Last Name:CANFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:212-297-6115
Mailing Address - Street 1:420 LEXINGTON AVE
Mailing Address - Street 2:RM 300
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10170-0002
Mailing Address - Country:US
Mailing Address - Phone:212-297-6115
Mailing Address - Fax:212-479-2515
Practice Address - Street 1:420 LEXINGTON AVE
Practice Address - Street 2:RM 300
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10170-0002
Practice Address - Country:US
Practice Address - Phone:212-297-6115
Practice Address - Fax:212-479-2515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-25
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018056103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA100086768Medicare PIN