Provider Demographics
NPI:1356955934
Name:HILLSIDE TMS MEDICAL PLLC
Entity type:Organization
Organization Name:HILLSIDE TMS MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNUPRIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:ITTEERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-859-5758
Mailing Address - Street 1:1575 HILLSIDE AVE STE 208
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-2501
Mailing Address - Country:US
Mailing Address - Phone:516-974-6072
Mailing Address - Fax:516-998-4133
Practice Address - Street 1:1575 HILLSIDE AVE STE 208
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-2501
Practice Address - Country:US
Practice Address - Phone:516-974-6072
Practice Address - Fax:516-998-4133
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTHWELL HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-09-01
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty