Provider Demographics
NPI:1952626863
Name:GHOSH PSYCHIATRIC SERVICES, LLC
Entity Type:Organization
Organization Name:GHOSH PSYCHIATRIC SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHUBHRANJAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GHOSH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:907-301-0943
Mailing Address - Street 1:9138 ARLON ST
Mailing Address - Street 2:B6
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-3876
Mailing Address - Country:US
Mailing Address - Phone:907-317-2053
Mailing Address - Fax:907-644-8099
Practice Address - Street 1:9138 ARLON ST
Practice Address - Street 2:STE B6
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-3876
Practice Address - Country:US
Practice Address - Phone:907-301-0943
Practice Address - Fax:907-644-8099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-02
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK127287225XM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XM0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistMental HealthGroup - Single Specialty