Provider Demographics
NPI:1285942169
Name:MULTIDISCIPLINARY PSYCHOLOGICAL SERVICES, P.S.C.
Entity type:Organization
Organization Name:MULTIDISCIPLINARY PSYCHOLOGICAL SERVICES, P.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ASTRID
Authorized Official - Middle Name:MARI
Authorized Official - Last Name:NEGRON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:787-479-1521
Mailing Address - Street 1:PO BOX 943
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-0943
Mailing Address - Country:US
Mailing Address - Phone:787-675-0663
Mailing Address - Fax:
Practice Address - Street 1:URB. AGUSTIN STAHL
Practice Address - Street 2:CARR 174 # 79 SUITE 3
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956
Practice Address - Country:US
Practice Address - Phone:787-675-0663
Practice Address - Fax:787-961-8018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-14
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5503103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR5503OtherPROFESSIONAL LICENSE