Provider Demographics
NPI:1679855142
Name:ROCKLAND CHILDREN'S PSYCHIATRIC CENTER
Entity Type:Organization
Organization Name:ROCKLAND CHILDREN'S PSYCHIATRIC CENTER
Other - Org Name:2 FIRST AVE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOCIAL WORKER II
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MAURO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:8450-358-8817
Mailing Address - Street 1:2 FIRST AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:NY
Mailing Address - Zip Code:10962
Mailing Address - Country:US
Mailing Address - Phone:845-358-8817
Mailing Address - Fax:845-358-8819
Practice Address - Street 1:65 PARROTT ROAD
Practice Address - Street 2:BLDG.6
Practice Address - City:WEST NYACK
Practice Address - State:NY
Practice Address - Zip Code:10994
Practice Address - Country:US
Practice Address - Phone:845-623-0085
Practice Address - Fax:845-627-6302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-12
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2683502283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital