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Organization
THERAPY WEST
Active
Organization
THERAPY WEST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY IAN KASSINOVE (CLINIICAL PSYCHOLOGY)
(212) 580-0080
Entity
Organization
Contact information
Practice address
124 W 79TH ST, SUITE 1B, NEW YORK, NY 10024
(212) 580-0080
(212) 580-0047
Mailing address
124 W 79TH ST, SUITE 1B, NEW YORK, NY 10024-6470
(212) 580-0080
(212) 580-0047
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
014602
NY
103T00000X
Psychologist
7549075
NY
103T00000X
Psychologist
P99046
NY
103T00000X
Psychologist
P99660
NY
Other
Enumeration date
12/21/2015
Last updated
12/21/2015
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