Provider Demographics
NPI:1487991733
Name:MINDWISE PSYCHOLOGY P.C.
Entity type:Organization
Organization Name:MINDWISE PSYCHOLOGY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:646-267-8047
Mailing Address - Street 1:441 WESTEND AVENUE
Mailing Address - Street 2:2C
Mailing Address - City:NY
Mailing Address - State:NY
Mailing Address - Zip Code:10024-6467
Mailing Address - Country:US
Mailing Address - Phone:646-267-8047
Mailing Address - Fax:
Practice Address - Street 1:441 WESTEND AVENUE
Practice Address - Street 2:2C
Practice Address - City:NY
Practice Address - State:NY
Practice Address - Zip Code:10024-6467
Practice Address - Country:US
Practice Address - Phone:646-267-8047
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103G00000X
NY0182131103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty