Provider Demographics
NPI:1245616069
Name:ADVANCED CENTER FOR PSYCHOTHERAPY
Entity Type:Organization
Organization Name:ADVANCED CENTER FOR PSYCHOTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE CHAIRMAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DINSHAW
Authorized Official - Middle Name:
Authorized Official - Last Name:BAMJI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-261-3330
Mailing Address - Street 1:10326 68TH RD
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-3200
Mailing Address - Country:US
Mailing Address - Phone:718-261-3330
Mailing Address - Fax:718-658-7091
Practice Address - Street 1:10326 68TH RD
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-3200
Practice Address - Country:US
Practice Address - Phone:718-261-3330
Practice Address - Fax:718-658-7091
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JAMAICA HOSPITAL MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-08-04
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP98809261QM0850X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health