Basic Information
| Provider Information | |||||||||
| NPI: | 1144393430 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ROCKLAND PSYCHIATRIC CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 893 WURTSBORO MOUNTAIN RD | ||||||||
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| City: | WURTSBORO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 127902108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8458888095 | ||||||||
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| Practice Location | |||||||||
| Address1: | 45 ASHLEY AVE. BUILDING 57 | ||||||||
| Address2: | |||||||||
| City: | MIDDLETOWN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10940 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8453436686 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/16/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | JORDAN | ||||||||
| AuthorizedOfficialFirstName: | MIRLANDE | ||||||||
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| AuthorizedOfficialTitleorPosition: | PSYCHIATRIST II | ||||||||
| AuthorizedOfficialTelephone: | 8453436686 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 283Q00000X | 204760 | NY | Y | Hospitals | Psychiatric Hospital |
No ID Information.