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General NPI Number Information
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NPI Number | 1114568375
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Entity Type | Organization
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Legal Business Name | BAY PSYCHIATRIC GROUP, INC
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Dates
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Enumeration Date | 09/30/2019
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Last Update Date | 09/30/2019
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Provider Practice Location Address
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Address Line | 923 FIRST COLONIAL RD STE 1821
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-3182
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Country | US
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Telephone | 757-478-2578
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Fax | 757-425-5011
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Provider Business Mailing Address
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Address Line | 923 FIRST COLONIAL RD STE 1821
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-3182
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Country | US
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Telephone | 757-478-2578
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Fax | 757-425-5011
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Authorized Official
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Title or Position | CEO
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Name | SEAN F REGAN
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Credential |
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Telephone | 757-425-5010
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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 |
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License Number State |
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