Provider Demographics
NPI:1023546389
Name:MEL BORNSTEIN CLINIC FOR PSYCHOANALYSIS AND PSYCHOTHERAPY
Entity Type:Organization
Organization Name:MEL BORNSTEIN CLINIC FOR PSYCHOANALYSIS AND PSYCHOTHERAPY
Other - Org Name:MEL BORNSTEIN CLINIC FOR PSYCHOANALYSIS AND PSYCHOTHERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DELEGATED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:AISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABBASI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-910-0315
Mailing Address - Street 1:PO BOX 85747
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53408-5747
Mailing Address - Country:US
Mailing Address - Phone:262-638-7442
Mailing Address - Fax:262-638-7455
Practice Address - Street 1:32841 MIDDLEBELT RD STE 403
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-1771
Practice Address - Country:US
Practice Address - Phone:248-910-0315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-31
Last Update Date:2017-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty