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Organization
PARK AVE PSYCHOTHERAPY
Active
Organization
PARK AVE PSYCHOTHERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANDREA RHONDA GITTER (DIRECTOR)
(718) 634-0253
Entity
Organization
Contact information
Practice address
167 BEACH 135TH ST., ROCKAWAY PARK, NY 11694-1303
(718) 634-0253
(718) 634-1056
Mailing address
167 BEACH 135TH ST., ROCKAWAY PARK, NY 11694-1303
(718) 634-0253
(718) 634-1056
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
R027402
NY
104100000X
Social Worker
Primary
R027402
NY
1041C0700X
Clinical Social Worker
R027402
NY
2084P0804X
Child & Adolescent Psychiatry Physician
R027402
NY
225600000X
Dance Therapist
05000472
NY
Other
Enumeration date
08/31/2012
Last updated
08/31/2012
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