Provider Demographics
NPI:1700032794
Name:ADAM, ANTOINE GISCARD (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTOINE
Middle Name:GISCARD
Last Name:ADAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 5TH AVE OFC 5
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-4342
Mailing Address - Country:US
Mailing Address - Phone:917-207-1244
Mailing Address - Fax:212-254-4456
Practice Address - Street 1:11 5TH AVE OFC 5
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4342
Practice Address - Country:US
Practice Address - Phone:917-207-1244
Practice Address - Fax:212-254-4456
Is Sole Proprietor?:No
Enumeration Date:2008-08-11
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2567112084P0800X, 2084P0804X
AZ429052084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry