Provider Demographics
NPI:1679995690
Name:BLC PSYCHOLOGY TRIBECA PLLC
Entity type:Organization
Organization Name:BLC PSYCHOLOGY TRIBECA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:GEISLER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:516-902-3902
Mailing Address - Street 1:79 CHAMBERS ST
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10007-1824
Mailing Address - Country:US
Mailing Address - Phone:516-902-3902
Mailing Address - Fax:
Practice Address - Street 1:79 CHAMBERS ST
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10007-1824
Practice Address - Country:US
Practice Address - Phone:516-902-3902
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-09
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty