Provider Demographics
NPI:1861867095
Name:CONTEMPORARY TMS OF MANHASSETT
Entity Type:Organization
Organization Name:CONTEMPORARY TMS OF MANHASSETT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TARIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:PERERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-482-0667
Mailing Address - Street 1:81 HOLLY HILL LN
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-6071
Mailing Address - Country:US
Mailing Address - Phone:203-482-0667
Mailing Address - Fax:
Practice Address - Street 1:1165 NORTHERN BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-3039
Practice Address - Country:US
Practice Address - Phone:203-482-0667
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-14
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039232305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service