Provider Demographics
NPI:1740959675
Name:CARE PSYCHIATRIC SERVICES PLLC
Entity type:Organization
Organization Name:CARE PSYCHIATRIC SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MADHU
Authorized Official - Middle Name:G
Authorized Official - Last Name:RAJANNA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-470-5011
Mailing Address - Street 1:3 WHEELER AVE
Mailing Address - Street 2:
Mailing Address - City:ALBERTSON
Mailing Address - State:NY
Mailing Address - Zip Code:11507-1609
Mailing Address - Country:US
Mailing Address - Phone:917-470-5011
Mailing Address - Fax:
Practice Address - Street 1:220 MINEOLA BLVD STE 8
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-2533
Practice Address - Country:US
Practice Address - Phone:516-742-0320
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-13
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty