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7 Skyline Dr Ste 350 Hawthorne NY 10532-2162 | |
| (857) 557-5777 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 7 Skyline Dr Ste 350, Hawthorne, New York |
| Authorized Official Name and Position | Ravi Patel (MEDICAL DIRECTOR) |
| Authorized Official Contact | 3523138000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
101 Arch St Fl 8 Boston MA 02110-7500 Ph: () - | 7 Skyline Dr Ste 350 Hawthorne NY 10532-2162 Ph: (857) 557-5777 |
| NPI Number | 1750076931 |
|---|---|
| Provider Enumeration Date | 04/05/2023 |
| Last Update Date | 08/01/2024 |
| Certification Date | 08/01/2024 |
| Medicare PECOS PAC ID | 9830546597 |
|---|---|
| Medicare Enrollment ID | O20231117000560 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750076931 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Brandy Deweese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982032629 PECOS PAC ID: 6800026519 Enrollment ID: I20241125002604 |
| Provider Name | Tanvi Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609429794 PECOS PAC ID: 7618208372 Enrollment ID: I20241211001598 |
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