Provider Demographics
NPI:1962761148
Name:PSYCHOANALYTIC TRAINING INSTITUTE OF THE CONTEMPORARY FREUDIAN SOCIETY
Entity type:Organization
Organization Name:PSYCHOANALYTIC TRAINING INSTITUTE OF THE CONTEMPORARY FREUDIAN SOCIETY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:STROBOULIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-446-4867
Mailing Address - Street 1:1173A 2ND AVE
Mailing Address - Street 2:#323
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-8277
Mailing Address - Country:US
Mailing Address - Phone:212-752-7883
Mailing Address - Fax:
Practice Address - Street 1:40 W 13TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-7940
Practice Address - Country:US
Practice Address - Phone:212-752-7883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-09
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health