| Penn Psychiatric Center Inc | |
|
601 Gay St Suite6 Phoenixville PA 19460-3852 | |
| (610) 917-2200 | |
| (610) 917-2360 |
| Full Name | Penn Psychiatric Center Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 601 Gay St, Phoenixville, Pennsylvania |
| Authorized Official Name and Position | Samir Farag (PRESIDENT PSYCHIATRIST) |
| Authorized Official Contact | 6109172200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Penn Psychiatric Center Inc Po Box 187 Gwynedd Valley PA 19437-0187 Ph: (610) 917-2200 | Penn Psychiatric Center Inc 601 Gay St Suite6 Phoenixville PA 19460-3852 Ph: (610) 917-2200 |
| NPI Number | 1952481616 |
|---|---|
| Provider Enumeration Date | 10/17/2006 |
| Last Update Date | 05/04/2012 |
| Medicare PECOS PAC ID | 9537055405 |
|---|---|
| Medicare Enrollment ID | O20040226000604 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952481616 | NPI | - | NPPES |
| 10753391 | Medicaid | PA |
| Provider Name | Samir F Farag |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285648329 PECOS PAC ID: 4880580752 Enrollment ID: I20050513000062 |
| Provider Name | George H.n. Adams |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891715538 PECOS PAC ID: 3072642271 Enrollment ID: I20100526000934 |
| Provider Name | Elizabeth J Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316368848 PECOS PAC ID: 9133342702 Enrollment ID: I20140529000950 |
| Provider Name | Gregory Williams |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033243779 PECOS PAC ID: 3274812680 Enrollment ID: I20161107002316 |
| Provider Name | Christine Martinez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659796118 PECOS PAC ID: 4981009578 Enrollment ID: I20210819002138 |
| Provider Name | Ayanna Logan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508535154 PECOS PAC ID: 0143628545 Enrollment ID: I20211025001839 |
| Provider Name | Christina A Ryder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841955465 PECOS PAC ID: 0446642565 Enrollment ID: I20220124001735 |
| Provider Name | Jennifer Busch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649953795 PECOS PAC ID: 7911350046 Enrollment ID: I20240125000863 |
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