Provider Demographics
NPI:1558630202
Name:S I BEHAVIORAL NETWORK, INC
Entity Type:Organization
Organization Name:S I BEHAVIORAL NETWORK, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPPORTIVE CASE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DANUTA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRZERADZKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-351-5530
Mailing Address - Street 1:777 SEAVIEW AVE
Mailing Address - Street 2:BLDG # 2
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-3409
Mailing Address - Country:US
Mailing Address - Phone:718-351-5530
Mailing Address - Fax:718-351-5639
Practice Address - Street 1:777 SEAVIEW AVE
Practice Address - Street 2:BLDG # 2
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-3409
Practice Address - Country:US
Practice Address - Phone:718-351-5530
Practice Address - Fax:718-351-5639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-27
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty