| Suffern Psychiatric Services Llc | |
|
255 Lafayette Ave Good Samaritan Hospital Behavior Health Dept Suffern NY 10901 | |
| (845) 368-5251 | |
| (845) 557-0300 |
| Full Name | Suffern Psychiatric Services Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 255 Lafayette Ave, Suffern, New York |
| Authorized Official Name and Position | Mahomed S Bhana (MANAGING DIRECTOR) |
| Authorized Official Contact | 8453685251 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Suffern Psychiatric Services Llc Po Box 797 New City NY 10956 Ph: (845) 557-0300 | Suffern Psychiatric Services Llc 255 Lafayette Ave Good Samaritan Hospital Behavior Health Dept Suffern NY 10901 Ph: (845) 368-5251 |
| NPI Number | 1497842876 |
|---|---|
| Provider Enumeration Date | 10/06/2006 |
| Last Update Date | 03/20/2008 |
| Medicare PECOS PAC ID | 8921015223 |
|---|---|
| Medicare Enrollment ID | O20091014000468 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497842876 | NPI | - | NPPES |
| 02753533 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 148678 (New York) | Primary |
| Provider Name | Mahomed S Bhana |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841387123 PECOS PAC ID: 7810904117 Enrollment ID: I20060321000628 |
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