Healthcare Provider Details

I. General information

NPI: 1326873266
Provider Name (Legal Business Name): ASCEND PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2024
Last Update Date: 09/02/2024
Certification Date: 09/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13101 40TH RD APT 15C
FLUSHING NY
11354-5245
US

IV. Provider business mailing address

13101 40TH RD APT 15C
FLUSHING NY
11354-5245
US

V. Phone/Fax

Practice location:
  • Phone: 908-361-7814
  • Fax:
Mailing address:
  • Phone: 908-361-7814
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MOHAMMED MAZHARUDDIN
Title or Position: MEMBER-MANAGER
Credential: MD
Phone: 908-361-7814