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Organization

STATEN ISLAND UNIVERSITY HOSPITAL BEHAVORIAL MEDICINE GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL T. LEVY (CHAIRMAN OF BEHAVIORIAL)
17182266170
Entity
Organization

Contact information

Practice address
475 SEAVIEW AVE, STATEN ISLAND, NY 10305-3436
(718) 226-4502
(718) 226-4875
Mailing address
475 SEAVIEW AVE, STATEN ISLAND, NY 10305-3436
(718) 226-4502
(718) 226-4875

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1041C0700X
Clinical Social Worker
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
2084P0800X
Psychiatry Physician
2084P0804X
Child & Adolescent Psychiatry Physician
2084P0805X
Geriatric Psychiatry Physician
363LP0808X
Psychiatric/Mental Health Nurse Practitioner

Other

Enumeration date
09/24/2007
Last updated
09/24/2007
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