Provider Demographics
NPI:1659580785
Name:MANHATTAN PSYCHOLOGICAL SERVICES
Entity Type:Organization
Organization Name:MANHATTAN PSYCHOLOGICAL SERVICES
Other - Org Name:MENTAL HEALTH RESOURCE GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:N
Authorized Official - Last Name:BRONDOLO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:212-942-8532
Mailing Address - Street 1:274 MADISON AVE
Mailing Address - Street 2:SUITE 1500
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-0701
Mailing Address - Country:US
Mailing Address - Phone:212-942-8532
Mailing Address - Fax:646-349-4126
Practice Address - Street 1:104 E 40TH ST
Practice Address - Street 2:SUITE 906
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-1801
Practice Address - Country:US
Practice Address - Phone:212-942-8532
Practice Address - Fax:646-349-4126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2015-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010163-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty