Provider Demographics
NPI:1154597219
Name:DR. IOSPA PSYCHIATRY CONSULTING, P.C.
Entity type:Organization
Organization Name:DR. IOSPA PSYCHIATRY CONSULTING, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLA
Authorized Official - Middle Name:
Authorized Official - Last Name:IOSPA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-662-2200
Mailing Address - Street 1:601 SURF AVE
Mailing Address - Street 2:17L
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-3450
Mailing Address - Country:US
Mailing Address - Phone:646-383-7575
Mailing Address - Fax:646-706-7788
Practice Address - Street 1:28 W 44TH ST
Practice Address - Street 2:SUITE 812
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-7406
Practice Address - Country:US
Practice Address - Phone:646-383-7575
Practice Address - Fax:646-706-7788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-07
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2289932084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty