Basic Information
| Provider Information | |||||||||
| NPI: | 1568824639 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MAP NY CONSULTING, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 365 SUNRISE HWY | ||||||||
| Address2: | |||||||||
| City: | LYNBROOK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115633027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5167377018 | ||||||||
| FaxNumber: | 5163313175 | ||||||||
| Practice Location | |||||||||
| Address1: | 365 SUNRISE HWY | ||||||||
| Address2: | |||||||||
| City: | LYNBROOK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115633027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5167377018 | ||||||||
| FaxNumber: | 5163313175 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2016 | ||||||||
| LastUpdateDate: | 04/11/2016 | ||||||||
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| AuthorizedOfficialLastName: | PESTRAK | ||||||||
| AuthorizedOfficialFirstName: | MARY | ||||||||
| AuthorizedOfficialMiddleName: | ANN | ||||||||
| AuthorizedOfficialTitleorPosition: | PSYCHIATRIC NURSE PRACTITIONER | ||||||||
| AuthorizedOfficialTelephone: | 5167377018 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | APRN | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM0850X | 401811 | NY | Y | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health |
No ID Information.