Provider Demographics
NPI:1528567005
Name:VM PSYCHOLOGICAL SERVICES, INC
Entity Type:Organization
Organization Name:VM PSYCHOLOGICAL SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VAIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TSOLAS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:212-221-4567
Mailing Address - Street 1:330 W 58TH ST STE 409
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1820
Mailing Address - Country:US
Mailing Address - Phone:212-221-4567
Mailing Address - Fax:
Practice Address - Street 1:330 W 58TH ST STE 409
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1820
Practice Address - Country:US
Practice Address - Phone:212-221-4567
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-09
Last Update Date:2018-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0106893-1103TP0814X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysisGroup - Multi-Specialty