Provider Demographics
NPI:1508262841
Name:EMILY EYERMAN THERAPY
Entity Type:Organization
Organization Name:EMILY EYERMAN THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:EYERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:516-655-8648
Mailing Address - Street 1:4540 CENTER BLVD
Mailing Address - Street 2:APT 2409
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11109-5792
Mailing Address - Country:US
Mailing Address - Phone:516-655-8648
Mailing Address - Fax:
Practice Address - Street 1:271 MADISON AVE
Practice Address - Street 2:SUITE 1400
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-1001
Practice Address - Country:US
Practice Address - Phone:347-878-5733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-14
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001003251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health