Organization
PSYCHIATRY ON VIDEO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YISSELL DELVALLE MD (MEDICAL DIRECTOR)
(201) 490-4075
Entity
Organization
Contact information
Practice address
162 E RIDGEWOOD AVE, RIDGEWOOD, NJ 07450-3859
(201) 470-4006
(201) 917-7871
Mailing address
6000 WASHINGTON ST, WEST NEW YORK, NJ 07093-1420
(201) 490-4075
(201) 917-7871
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
03/01/2022
Last updated
08/25/2023
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