Provider Demographics
NPI:1952600348
Name:NIFKAB
Entity Type:Organization
Organization Name:NIFKAB
Other - Org Name:CLINICAL PSYCHOTHERAPY AND COUNSELING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:BARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-351-4884
Mailing Address - Street 1:POST OFFICE BOX 60725
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-0725
Mailing Address - Country:US
Mailing Address - Phone:718-815-3500
Mailing Address - Fax:718-760-6064
Practice Address - Street 1:981 BAY ST
Practice Address - Street 2:SUITE NUMBER 6
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-4903
Practice Address - Country:US
Practice Address - Phone:718-815-3500
Practice Address - Fax:718-764-6064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-24
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health