Provider Demographics
NPI:1710008339
Name:CHILD & FAMILY MEDICAL, PLLC
Entity Type:Organization
Organization Name:CHILD & FAMILY MEDICAL, PLLC
Other - Org Name:THERAPY CENTER OF NEW YORK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:INAMDAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-725-0192
Mailing Address - Street 1:34 S BROADWAY STE 711
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-4427
Mailing Address - Country:US
Mailing Address - Phone:914-946-4700
Mailing Address - Fax:914-285-5723
Practice Address - Street 1:34 S BROADWAY STE 711
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-4427
Practice Address - Country:US
Practice Address - Phone:914-946-4700
Practice Address - Fax:914-285-5723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0147861103T00000X
NY162541103TB0200X
NY0137821103TC0700X
NY0161771103TC0700X
NY05493711041C0700X
NY06998611041C0700X
NY07369411041C0700X
NY11405812084P0800X
NY22684912084P0800X
2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1386686855OtherNPI NUMBER
NY1710008339OtherCFBHP GROUP NPI
NY1063562650OtherNPI
NY1316954258OtherNPI
NY1427108976OtherNPI
NY1215087655OtherNPI
NY1710008339OtherCFBHP GROUP NPI
NY1316954258OtherNPI
NY1730239211OtherNPI
NY1497805824OtherNPI
NY1710008339OtherCFBHP GROUP NPI
NYB16550Medicare UPIN