Provider Demographics
NPI:1003502717
Name:MODERN PSYCHIATRY PC
Entity Type:Organization
Organization Name:MODERN PSYCHIATRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRY
Authorized Official - Prefix:
Authorized Official - First Name:DANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-605-1506
Mailing Address - Street 1:39000 7 MILE RD # 3100
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-1006
Mailing Address - Country:US
Mailing Address - Phone:734-743-3480
Mailing Address - Fax:
Practice Address - Street 1:39000 7 MILE RD # 3100
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-1006
Practice Address - Country:US
Practice Address - Phone:734-743-3480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-14
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty