Provider Demographics
NPI:1649595406
Name:EMILY R. LANTZ PSYD PC
Entity Type:Organization
Organization Name:EMILY R. LANTZ PSYD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:R
Authorized Official - Last Name:LANTZ
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:914-860-6608
Mailing Address - Street 1:200 S BROADWAY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-4500
Mailing Address - Country:US
Mailing Address - Phone:914-860-6608
Mailing Address - Fax:914-502-0120
Practice Address - Street 1:200 S BROADWAY
Practice Address - Street 2:SUITE 201
Practice Address - City:TARRYTOWN
Practice Address - State:NY
Practice Address - Zip Code:10591-4500
Practice Address - Country:US
Practice Address - Phone:914-860-6608
Practice Address - Fax:914-502-0120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-05
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & AgingGroup - Single Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty