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General NPI Number Information
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NPI Number | 1043341324
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Entity Type | Organization
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Legal Business Name | ADVANCED PSYCHIATRIC CARE PC
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 10/15/2007
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Provider Practice Location Address
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Address Line | 99 BRIGHTON 11 STREET
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City | BROOKLYN
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State | NY
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Zip | 11235
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Country | US
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Telephone | 718-238-2285
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Fax | 718-332-7412
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Provider Business Mailing Address
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Address Line | 345 82ND STREET
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City | BROOKLYN
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State | NY
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Zip | 11209
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Country | US
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Telephone | 718-238-2285
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Fax | 718-332-7412
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Authorized Official
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Title or Position | PHYSICIAN
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Name | ANNA KHARITONOVA
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Credential | DO
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Telephone | 718-238-2285
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 208942
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License Number State | NY
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