Provider Demographics
NPI:1386284594
Name:PILON HARLEM, LLC
Entity type:Organization
Organization Name:PILON HARLEM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LYRICA
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:FILS-AIME
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R
Authorized Official - Phone:347-541-5695
Mailing Address - Street 1:753 SAINT NICHOLAS AVE APT 4B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10031-4953
Mailing Address - Country:US
Mailing Address - Phone:347-541-5695
Mailing Address - Fax:
Practice Address - Street 1:753 SAINT NICHOLAS AVE APT 1A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10031-4953
Practice Address - Country:US
Practice Address - Phone:631-374-3038
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-15
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health