Provider Demographics
NPI:1730650284
Name:NEUROPSYCHOLOGICAL SERVICES OF ASTORIA PLLC
Entity Type:Organization
Organization Name:NEUROPSYCHOLOGICAL SERVICES OF ASTORIA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERNESTO
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:716-721-0330
Mailing Address - Street 1:3027 30TH ST FL 1
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-2261
Mailing Address - Country:US
Mailing Address - Phone:718-721-0330
Mailing Address - Fax:718-721-0355
Practice Address - Street 1:3027 30TH ST FL 1
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-2261
Practice Address - Country:US
Practice Address - Phone:718-721-0330
Practice Address - Fax:718-721-0355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-10
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)