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Contact Information

MANDALA PSYCHOLOGICAL SERVICES, P.C.
2785 W 5TH ST APT 10E
BROOKLYN, NY11224-4612
 Phone: 646-415-1915
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for MANDALA PSYCHOLOGICAL SERVICES, P.C.

NPI Number 1922164383
LBN Legal business name MANDALA PSYCHOLOGICAL SERVICES, P.C.
Authorized official YELENA RAZDOLSKAYA - (PSYCHOLOGIST)
Entity Organization
Organization subpart 1 No
Enumeration date 12/29/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
NY License # 016210
NY Medicaid 02821658
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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