Organization
MINDED, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELANA LISCH (DIRECTOR OF CLINICAL OPERATIONS)
(909) 442-0618
Entity
Organization
Contact information
Practice address
122 GRAND ST, NEW YORK, NY 10013-2614
(909) 442-0618
Mailing address
122 GRAND ST, NEW YORK, NY 10013-2614
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
07/19/2022
Last updated
01/18/2023
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