Provider Demographics
NPI:1902591274
Name:UPPER EAST SIDE PSYCHOLOGY
Entity Type:Organization
Organization Name:UPPER EAST SIDE PSYCHOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GABRIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHREYER-HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:917-773-8674
Mailing Address - Street 1:60 E END AVE APT 20C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-7945
Mailing Address - Country:US
Mailing Address - Phone:917-773-8674
Mailing Address - Fax:
Practice Address - Street 1:60 E END AVE APT 20C
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-7945
Practice Address - Country:US
Practice Address - Phone:917-773-8674
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-11
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty