Provider Demographics
NPI:1851532196
Name:RIVERTOWNS PSYCHOLOGICAL ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:RIVERTOWNS PSYCHOLOGICAL ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:TAYLOR
Authorized Official - Last Name:DYKE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:914-400-3588
Mailing Address - Street 1:545 SAW MILL RIVER RD
Mailing Address - Street 2:SUITE 3C-S1
Mailing Address - City:ARDSLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10502-2157
Mailing Address - Country:US
Mailing Address - Phone:914-329-0759
Mailing Address - Fax:914-478-5192
Practice Address - Street 1:875 W END AVE
Practice Address - Street 2:SUITE 1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-4919
Practice Address - Country:US
Practice Address - Phone:914-400-3588
Practice Address - Fax:914-478-5192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-17
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013148-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty