Provider Demographics
NPI:1841397890
Name:METROCENTER PSYCHIATRY PLLC
Entity Type:Organization
Organization Name:METROCENTER PSYCHIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROSENGARD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:602-943-3100
Mailing Address - Street 1:5501 N 7TH AVE # 226
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-1756
Mailing Address - Country:US
Mailing Address - Phone:602-943-3100
Mailing Address - Fax:602-943-3122
Practice Address - Street 1:10000 N 31ST AVE STE D201
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85051-9570
Practice Address - Country:US
Practice Address - Phone:602-943-3100
Practice Address - Fax:602-943-3122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ20562084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty