Provider Demographics
NPI:1821241738
Name:METRO PSYCHIATRY PC
Entity Type:Organization
Organization Name:METRO PSYCHIATRY PC
Other - Org Name:MICHELLE WIDLITZ MD
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:WIDLITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-452-3485
Mailing Address - Street 1:300 E 71ST ST
Mailing Address - Street 2:16H
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-5234
Mailing Address - Country:US
Mailing Address - Phone:212-249-4777
Mailing Address - Fax:
Practice Address - Street 1:276 5TH AVE
Practice Address - Street 2:SUITE 1101
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-4509
Practice Address - Country:US
Practice Address - Phone:347-452-3485
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-23
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2189632084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty