Provider Demographics
NPI:1124063664
Name:GERIATRIC PSYCHOLOGICAL SERVICES PC
Entity type:Organization
Organization Name:GERIATRIC PSYCHOLOGICAL SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGARO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:718-268-6600
Mailing Address - Street 1:PO BOX 750834
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11375-0834
Mailing Address - Country:US
Mailing Address - Phone:718-268-6600
Mailing Address - Fax:
Practice Address - Street 1:118-35 QUEENS BLVD.
Practice Address - Street 2:SUITE 1403
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-7205
Practice Address - Country:US
Practice Address - Phone:718-268-6600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011244103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV6W241Medicare ID - Type UnspecifiedEMPIRE
NYP60848Medicare UPIN