Provider Demographics
NPI:1164678397
Name:TEPPER & TEPPER PSYCHOLOGY PC
Entity type:Organization
Organization Name:TEPPER & TEPPER PSYCHOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:J
Authorized Official - Last Name:TEPPER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:212-787-5250
Mailing Address - Street 1:300 CENTRAL PARK W
Mailing Address - Street 2:APT. 3J
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-1513
Mailing Address - Country:US
Mailing Address - Phone:212-787-5250
Mailing Address - Fax:212-787-9407
Practice Address - Street 1:300 CENTRAL PARK W
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-1513
Practice Address - Country:US
Practice Address - Phone:212-787-5250
Practice Address - Fax:212-787-9407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-07
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-008299-L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PATE064816Medicare PIN