Provider Demographics
NPI:1154337327
Name:AGING MATTERS PSYCHOLOGICAL SERVICES, PC
Entity type:Organization
Organization Name:AGING MATTERS PSYCHOLOGICAL SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TOMASSO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:914-681-9435
Mailing Address - Street 1:AGING MATTERS PSYCHOLOGICAL SERVICES, PC
Mailing Address - Street 2:34 SOUTH BROADWAY SUITE 600
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601
Mailing Address - Country:US
Mailing Address - Phone:914-681-9435
Mailing Address - Fax:914-231-9148
Practice Address - Street 1:34 SOUTH BROADWAY SUITE 600
Practice Address - Street 2:AGING MATTERS PSYCHOLOGICAL SERVICES, PC
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601
Practice Address - Country:US
Practice Address - Phone:914-681-9435
Practice Address - Fax:914-231-9148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02723917Medicaid
NY02723917Medicaid