| Gwinnett Psychiatry, P.c. | |
|
170 Camden Hill Rd Suite C Lawrenceville GA 30046-7418 | |
| (678) 226-2295 | |
| (678) 226-2296 |
| Full Name | Gwinnett Psychiatry, P.c. |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 170 Camden Hill Rd, Lawrenceville, Georgia |
| Authorized Official Name and Position | Nasira Rubina (PRESIDENT) |
| Authorized Official Contact | 6787496063 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gwinnett Psychiatry, P.c. 170 Camden Hill Rd Suite C Lawrenceville GA 30046-7418 Ph: (678) 226-2295 | Gwinnett Psychiatry, P.c. 170 Camden Hill Rd Suite C Lawrenceville GA 30046-7418 Ph: (678) 226-2295 |
| NPI Number | 1720110398 |
|---|---|
| Provider Enumeration Date | 03/09/2007 |
| Last Update Date | 06/06/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720110398 | NPI | - | NPPES |
| 648074039A | Medicaid | GA | |
| 10068469 | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 056642 (Georgia) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | 056642 (Georgia) | Primary |
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