| Innovative Psychiatricare Pc | |
|
165 Lefferts Rd Woodmere NY 11598-1347 | |
| (516) 569-1027 | |
| Not Available |
| Full Name | Innovative Psychiatricare Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 165 Lefferts Rd, Woodmere, New York |
| Authorized Official Name and Position | Richard A Krugley (OWNER) |
| Authorized Official Contact | 5165691027 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovative Psychiatricare Pc 165 Lefferts Rd Woodmere NY 11598-1347 Ph: (516) 569-1027 | Innovative Psychiatricare Pc 165 Lefferts Rd Woodmere NY 11598-1347 Ph: (516) 569-1027 |
| NPI Number | 1730460171 |
|---|---|
| Provider Enumeration Date | 08/30/2011 |
| Last Update Date | 08/04/2017 |
| Medicare PECOS PAC ID | 8921279290 |
|---|---|
| Medicare Enrollment ID | O20110916000145 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730460171 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 132755 (New York) | Primary |
| Provider Name | Richard A Krugley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366430217 PECOS PAC ID: 6002835022 Enrollment ID: I20051118000028 |
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