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General NPI Number Information
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NPI Number | 1033443882
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Entity Type | Organization
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Legal Business Name | PSYCHIATRIC CARE CONSULTANTS LLC
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Dates
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Enumeration Date | 09/28/2009
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Last Update Date | 09/28/2009
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Provider Practice Location Address
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Address Line | 111 PARK ST SUITE 1G
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City | NEW HAVEN
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State | CT
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Zip | 06511-5412
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Country | US
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Telephone | 203-562-0223
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Fax | 203-777-4226
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Provider Business Mailing Address
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Address Line | 111 PARK ST SUITE 1G
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City | NEW HAVEN
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State | CT
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Zip | 06511-5412
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Country | US
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Telephone | 203-562-0223
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Fax | 203-777-4226
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Authorized Official
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Title or Position | PRESIDENT
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Name | KISHORCHANDRA R GONSAI
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Credential | MD
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Telephone | 203-562-0223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 036772
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License Number State | CT
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