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1013555861 NPI number — CLEAR MIND PSYCHIARTY OF MANHATTAN

NPI Number: 1013555861
Health Care Provider/Practitioner: CLEAR MIND PSYCHIARTY OF MANHATTAN

Information about “1013555861” NPI (CLEAR MIND PSYCHIARTY OF MANHATTAN) exists in 1013555861 in HTML format HTML  |  1013555861 in plain Text format TXT  |  1013555861 in PDF (Portable Document Format) PDF  |  1013555861 in an XML format XML  formats.

NPI Number : 1013555861 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1013555861",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "CLEAR MIND PSYCHIARTY OF MANHATTAN",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "6238 DIETERLE CRES",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "REGO PARK",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "11374-4836",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "917-981-9086",
    "MailingAddressFaxNumber": "917-477-2278",
    "FirstLinePracticeLocationAddress": "276 5TH AVE RM 1101",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NEW YORK",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "10001-4544",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "917-981-9086",
    "PracticeLocationAddressFaxNumber": "917-477-2278",
    "EnumerationDate": "12/11/2019",
    "LastUpdateDate": "06/11/2020",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "KHAIMOV",
    "AuthorizedOfficialFirstName": "BORIS",
    "AuthorizedOfficialMiddleName": "A",
    "AuthorizedOfficialTitle": "PSYCHIATRY",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "DO",
    "AuthorizedOfficialTelephoneNumber": "917-981-9086",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "2084P0800X",
        "TaxonomyName": "Psychiatry Physician",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
      }
    }
  }
}
                
            

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