| Full Circle Health, Pllc | |
|
1136 Neill Avenue Bronx NY 10461-2108 | |
| (718) 518-7600 | |
| (718) 518-7647 |
| Full Name | Full Circle Health, Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1136 Neill Avenue, Bronx, New York |
| Authorized Official Name and Position | Derek H. Suite (PSYCHIATRIST) |
| Authorized Official Contact | 7185187600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Full Circle Health, Pllc 1136 Neill Ave Bronx NY 10461-1328 Ph: (718) 518-7600 | Full Circle Health, Pllc 1136 Neill Avenue Bronx NY 10461-2108 Ph: (718) 518-7600 |
| NPI Number | 1952595050 |
|---|---|
| Provider Enumeration Date | 08/31/2007 |
| Last Update Date | 11/17/2015 |
| Medicare PECOS PAC ID | 5395634000 |
|---|---|
| Medicare Enrollment ID | O20080205000511 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952595050 | NPI | - | NPPES |
| 02501820 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Derek H Suite |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467433862 PECOS PAC ID: 2466465604 Enrollment ID: I20060711000168 |
| Provider Name | Jeffrey Barrett |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1316455454 PECOS PAC ID: 5294128948 Enrollment ID: I20220202000947 |
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