Provider Demographics
NPI:1437313822
Name:PSCH. INC
Entity type:Organization
Organization Name:PSCH. INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP FINANCE CLINICAL SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA-HERRERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-542-4217
Mailing Address - Street 1:142-02 20TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11351-9712
Mailing Address - Country:US
Mailing Address - Phone:718-559-0516
Mailing Address - Fax:718-762-6140
Practice Address - Street 1:153-17 JAMAICA AVE
Practice Address - Street 2:FL3
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-3822
Practice Address - Country:US
Practice Address - Phone:718-297-1718
Practice Address - Fax:718-297-2264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-15
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02712054Medicaid