| Island Psychiatric Care | |
|
6277 Jericho Tpke Commack NY 11725-2837 | |
| (631) 628-6868 | |
| (631) 628-6869 |
| Full Name | Island Psychiatric Care |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 6277 Jericho Tpke, Commack, New York |
| Authorized Official Name and Position | Asra F Siddiqi (OWNER/OPERATOR) |
| Authorized Official Contact | 6316236868 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Island Psychiatric Care 6277 Jericho Tpke Commack NY 11725-2837 Ph: (631) 628-6868 | Island Psychiatric Care 6277 Jericho Tpke Commack NY 11725-2837 Ph: (631) 628-6868 |
| NPI Number | 1649532797 |
|---|---|
| Provider Enumeration Date | 06/14/2012 |
| Last Update Date | 11/16/2023 |
| Certification Date | 11/16/2023 |
| Medicare PECOS PAC ID | 3274788427 |
|---|---|
| Medicare Enrollment ID | O20130219000567 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649532797 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | 232678 (New York) | Primary |
| Provider Name | Asra Siddiqi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013007715 PECOS PAC ID: 1850537994 Enrollment ID: I20130416000695 |
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