Provider Demographics
NPI:1912271891
Name:EPILEPSY INSTITUTE
Entity Type:Organization
Organization Name:EPILEPSY INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:PAUSIC
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:212-677-8550
Mailing Address - Street 1:257 PARK AVE S RM 302
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-7382
Mailing Address - Country:US
Mailing Address - Phone:212-677-8550
Mailing Address - Fax:212-677-8552
Practice Address - Street 1:257 PARK AVE S RM 302
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-7382
Practice Address - Country:US
Practice Address - Phone:212-677-8550
Practice Address - Fax:212-677-8552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-24
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY085077251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health