Provider Demographics
NPI:1902432073
Name:MYLING SUMANTI PSYCHOLOGY PC
Entity type:Organization
Organization Name:MYLING SUMANTI PSYCHOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MYLING
Authorized Official - Middle Name:
Authorized Official - Last Name:SUMANTI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:513-368-3722
Mailing Address - Street 1:150 MOTOR PKWY STE 401
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-5108
Mailing Address - Country:US
Mailing Address - Phone:513-368-3722
Mailing Address - Fax:888-786-2684
Practice Address - Street 1:150 MOTOR PKWY STE 401
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-5108
Practice Address - Country:US
Practice Address - Phone:888-786-2684
Practice Address - Fax:888-786-2684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-20
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)