Provider Demographics
NPI:1528080603
Name:WESTCHESTER FACULTY PSYCHOLOGICAL ASSOCIATES PC
Entity type:Organization
Organization Name:WESTCHESTER FACULTY PSYCHOLOGICAL ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:A
Authorized Official - Last Name:SEMMELRATH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-496-8198
Mailing Address - Street 1:40 SUNSHINE COTTAGE ROAD
Mailing Address - Street 2:NYMC-PSYCHIATRY
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595
Mailing Address - Country:US
Mailing Address - Phone:914-493-8198
Mailing Address - Fax:914-493-1015
Practice Address - Street 1:100 WOODS ROAD
Practice Address - Street 2:TAYLOR PAVILION NORTH
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1530
Practice Address - Country:US
Practice Address - Phone:914-493-8198
Practice Address - Fax:914-493-1015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-24
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004185103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02922058Medicaid
NY02922058Medicaid