Provider Demographics
NPI:1245637701
Name:NEW DAWN PSYCHIATRIC SERVICES, PLLC
Entity type:Organization
Organization Name:NEW DAWN PSYCHIATRIC SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MD
Authorized Official - Prefix:DR
Authorized Official - First Name:PUNITHA
Authorized Official - Middle Name:
Authorized Official - Last Name:RATHNAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:252-686-8093
Mailing Address - Street 1:400 GLENWOOD AVE
Mailing Address - Street 2:SUITE 8
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28501-3870
Mailing Address - Country:US
Mailing Address - Phone:252-686-8092
Mailing Address - Fax:252-686-8092
Practice Address - Street 1:400 GLENWOOD AVE
Practice Address - Street 2:SUITE 8
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-3870
Practice Address - Country:US
Practice Address - Phone:252-686-8092
Practice Address - Fax:252-686-8092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-28
Last Update Date:2014-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2010-01045251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health