Provider Demographics
NPI:1902001274
Name:LEIDE PORCU PHD PSYCHOANALYSIS PC
Entity Type:Organization
Organization Name:LEIDE PORCU PHD PSYCHOANALYSIS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LEIDE
Authorized Official - Middle Name:
Authorized Official - Last Name:PORCU
Authorized Official - Suffix:
Authorized Official - Credentials:NCPSYA
Authorized Official - Phone:212-929-7724
Mailing Address - Street 1:208 W 23RD ST APT 516
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-2309
Mailing Address - Country:US
Mailing Address - Phone:212-929-7724
Mailing Address - Fax:
Practice Address - Street 1:208 W 23RD ST APT 516
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-2309
Practice Address - Country:US
Practice Address - Phone:212-929-7724
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNCPSYA 000210101Y00000X, 101YM0800X, 102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Not Answered102L00000XBehavioral Health & Social Service ProvidersPsychoanalystGroup - Multi-Specialty