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Organization
PARK SLOPE PSYCHOLOGICAL SERVICES, LLC
Active
Organization
PARK SLOPE PSYCHOLOGICAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE PHUNG (PRESIDENT)
(800) 275-3243
Entity
Organization
Contact information
Practice address
319 18TH ST APT 3A, BROOKLYN, NY 11215-6109
(917) 545-7503
(800) 275-3671
Mailing address
319 18TH ST APT 3A, BROOKLYN, NY 11215-6109
(917) 545-7503
(800) 275-3671
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
016099-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02726185
—
NY
Enumeration date
04/30/2008
Last updated
04/30/2008
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