Healthcare Provider Details

I. General information

NPI: 1598236283
Provider Name (Legal Business Name): NYC PSYCHIATRIST SERVICES P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2018
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

58 N 9TH ST STE 103
BROOKLYN NY
11249-2018
US

IV. Provider business mailing address

PO BOX 96268
PHOENIX AZ
85072-6268
US

V. Phone/Fax

Practice location:
  • Phone: 929-346-4317
  • Fax: 929-360-0745
Mailing address:
  • Phone: 917-970-2934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. CARLENE MACMILLAN
Title or Position: CO-OWNER
Credential: MD
Phone: 929-227-6577