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SUFFOLK PSYCHIATRIC GROUP NPI 1265514954


NPI Information

NPI: 1265514954
Provider Name: SUFFOLK PSYCHIATRIC GROUP

Doing Business As: SUFFOLK PSYCHIATRIC GROUP

Classification: Specialist - 174400000X
Entity Type: Organization
Address:
2470 PRUDEN BLVD
SUFFOLK, VA
ZIP 23434
Phone: (757) 539-1503
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SUFFOLK PSYCHIATRIC GROUP is a specialist in Suffolk, VA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. SUFFOLK PSYCHIATRIC GROUP NPI is 1265514954. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Suffolk Psychiatric Group.

The provider's business location address is:

2470 PRUDEN BLVD
SUFFOLK, VA
ZIP 23434-206
Phone: (757) 539-1503
Fax: (757) 539-0107

The provider's authorized official is Haydeh Esmaili .
The authorized official title is Owner and has the following contact phone number (757) 539-1503.

The enumeration date for this NPI number is 10/20/2006 and was last updated on 4/28/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialist0101039180VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1010413761MEDICAIDVIRGINIA
2260000820MEDICARE UPINVIRGINIA
3=========OTHERVIRGINIATAX ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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