Provider Demographics
NPI:1366501207
Name:FISHKILL CONSULTATION GROUP
Entity type:Organization
Organization Name:FISHKILL CONSULTATION GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:NANCY
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:845-896-6751
Mailing Address - Street 1:1064 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:FISHKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12524
Mailing Address - Country:US
Mailing Address - Phone:845-896-6751
Mailing Address - Fax:845-227-2524
Practice Address - Street 1:1064 MAIN STREET
Practice Address - Street 2:
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524
Practice Address - Country:US
Practice Address - Phone:845-896-6751
Practice Address - Fax:845-227-2524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011544 1103T00000X
NY010262 1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV70841Medicare ID - Type Unspecified
137430Medicare UPIN