Provider Demographics
NPI:1194318386
Name:TRISTATE PSYCHOLOGICAL INJURY SERVICES PC
Entity type:Organization
Organization Name:TRISTATE PSYCHOLOGICAL INJURY SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHD
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:LLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:718-889-7445
Mailing Address - Street 1:8778 BAY PKWY FL 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-5653
Mailing Address - Country:US
Mailing Address - Phone:718-889-7445
Mailing Address - Fax:718-889-7458
Practice Address - Street 1:8778 BAY PKWY FL 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-5653
Practice Address - Country:US
Practice Address - Phone:718-889-7445
Practice Address - Fax:718-889-7458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-18
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty