Provider Demographics
NPI:1194376665
Name:ARCADIAN TELEPSYCHIATRY KANSAS P.A.
Entity Type:Organization
Organization Name:ARCADIAN TELEPSYCHIATRY KANSAS P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRONSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-641-2525
Mailing Address - Street 1:1300 VIRGINIA DR STE 110
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19034-3223
Mailing Address - Country:US
Mailing Address - Phone:215-641-2525
Mailing Address - Fax:
Practice Address - Street 1:1300 VIRGINIA DR STE 110
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:19034-3223
Practice Address - Country:US
Practice Address - Phone:215-641-2525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-25
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health