Provider Demographics
NPI:1952763963
Name:ACACIA PSYCHIATRIC SERVICES PC
Entity Type:Organization
Organization Name:ACACIA PSYCHIATRIC SERVICES PC
Other - Org Name:DENNIS POPEO, MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:POPEO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-584-7109
Mailing Address - Street 1:29 WEST 36TH STREET
Mailing Address - Street 2:APT 5B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018
Mailing Address - Country:US
Mailing Address - Phone:646-584-7109
Mailing Address - Fax:914-462-3599
Practice Address - Street 1:250 W 24TH ST
Practice Address - Street 2:APT 5BW
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-1703
Practice Address - Country:US
Practice Address - Phone:646-584-7109
Practice Address - Fax:914-462-3599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-28
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY224044101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty