| Supportive Care Psychiatry Of Ny Pc | |
|
7810 164th St Fresh Meadows NY 11366-1229 | |
| (866) 708-1240 | |
| Not Available |
| Full Name | Supportive Care Psychiatry Of Ny Pc |
|---|---|
| Speciality | Psychologist |
| Location | 7810 164th St, Fresh Meadows, New York |
| Authorized Official Name and Position | Dov Newmark (CEO) |
| Authorized Official Contact | 7182982753 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Supportive Care Psychiatry Of Ny Pc 27 Randolph Rd Howell NJ 07731-8611 Ph: () - | Supportive Care Psychiatry Of Ny Pc 7810 164th St Fresh Meadows NY 11366-1229 Ph: (866) 708-1240 |
| NPI Number | 1740994433 |
|---|---|
| Provider Enumeration Date | 01/09/2023 |
| Last Update Date | 01/09/2023 |
| Certification Date | 01/09/2023 |
| Medicare PECOS PAC ID | 4981076247 |
|---|---|
| Medicare Enrollment ID | O20230214002558 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740994433 | NPI | - | NPPES |
| Provider Name | Lorna C Forbes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477873776 PECOS PAC ID: 6901093269 Enrollment ID: I20101213000448 |
| Provider Name | Jorge Aguilar Zanatta |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477704971 PECOS PAC ID: 9335396969 Enrollment ID: I20200925001096 |
| Provider Name | Keith Steven Frawley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760252522 PECOS PAC ID: 9739523812 Enrollment ID: I20240216000643 |
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