Healthcare Provider Details

I. General information

NPI: 1669290490
Provider Name (Legal Business Name): ASHWOOD PSYCHIATRIC SERVICES P.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2024
Last Update Date: 10/01/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2740 WESTERVELT AVE
BRONX NY
10469-6124
US

IV. Provider business mailing address

2740 WESTERVELT AVE
BRONX NY
10469-6124
US

V. Phone/Fax

Practice location:
  • Phone: 585-905-9134
  • Fax:
Mailing address:
  • Phone: 718-908-0069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: ARMAN GARCH
Title or Position: CREDENTIALING OFFICER
Credential:
Phone: 585-905-9134