Provider Demographics
NPI:1083213854
Name:IMPERIAL PSYCHIATRIC SERVICES LLC
Entity Type:Organization
Organization Name:IMPERIAL PSYCHIATRIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMELDA
Authorized Official - Middle Name:
Authorized Official - Last Name:NJEI
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:302-724-1181
Mailing Address - Street 1:547 RIVERSIDE DR STE A
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-5369
Mailing Address - Country:US
Mailing Address - Phone:410-572-4738
Mailing Address - Fax:410-572-4649
Practice Address - Street 1:547 RIVERSIDE DR STE A
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-5369
Practice Address - Country:US
Practice Address - Phone:410-572-4738
Practice Address - Fax:410-572-4649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-22
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & NeuropsychiatryGroup - Multi-Specialty