Provider Demographics
NPI:1255701421
Name:OPUS PSYCHOLOGICAL SERVICES, P.C
Entity type:Organization
Organization Name:OPUS PSYCHOLOGICAL SERVICES, P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CAJETAN
Authorized Official - Middle Name:O
Authorized Official - Last Name:UCHENDU
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:516-410-5475
Mailing Address - Street 1:4360 DOUGLASTON PKWY
Mailing Address - Street 2:SUITE 221
Mailing Address - City:DOUGLASTON
Mailing Address - State:NY
Mailing Address - Zip Code:11363-1838
Mailing Address - Country:US
Mailing Address - Phone:516-410-5475
Mailing Address - Fax:
Practice Address - Street 1:4360 DOUGLASTON PKWY
Practice Address - Street 2:SUITE 221
Practice Address - City:DOUGLASTON
Practice Address - State:NY
Practice Address - Zip Code:11363-1838
Practice Address - Country:US
Practice Address - Phone:516-410-5475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-01
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017458-1261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)