Provider Demographics
NPI:1487989984
Name:JANET C WATERHOUSE CP PHD LLC
Entity type:Organization
Organization Name:JANET C WATERHOUSE CP PHD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORIGINAL MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANET
Authorized Official - Middle Name:C
Authorized Official - Last Name:WATERHOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-239-7792
Mailing Address - Street 1:186 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-1007
Mailing Address - Country:US
Mailing Address - Phone:917-239-7792
Mailing Address - Fax:212-721-5059
Practice Address - Street 1:315 W 57TH ST
Practice Address - Street 2:SUITE 305
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-3158
Practice Address - Country:US
Practice Address - Phone:917-239-7792
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-16
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017956103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty