Healthcare Provider Details

I. General information

NPI: 1407972755
Provider Name (Legal Business Name): CLINICAL PSYCHIATRY CONSULTANTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 10/09/2024
Certification Date: 10/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 N STATE RT 17 STE 250
PARAMUS NJ
07652-2821
US

IV. Provider business mailing address

140 N STATE RT 17 STE 250
PARAMUS NJ
07652-2821
US

V. Phone/Fax

Practice location:
  • Phone: 201-225-2555
  • Fax: 201-335-0835
Mailing address:
  • Phone: 631-839-1880
  • Fax: 201-335-0835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number25MA08125900
License Number StateNJ

VIII. Authorized Official

Name: SYED A RASHEED
Title or Position: OWNER
Credential: MD
Phone: 631-839-1880