Healthcare Provider Details

I. General information

NPI: 1841032356
Provider Name (Legal Business Name): CONCIERGE PSYCHIATRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2024
Last Update Date: 06/07/2024
Certification Date: 06/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1129 NORTHERN BLVD STE 404
MANHASSET NY
11030-3022
US

IV. Provider business mailing address

418 BROADWAY STE N
ALBANY NY
12207-2922
US

V. Phone/Fax

Practice location:
  • Phone: 516-373-9334
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JINGNA ZHAO
Title or Position: OWNER
Credential: MD
Phone: 516-445-5393