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General NPI Number Information
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NPI Number | 1134996069
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Entity Type | Organization
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Legal Business Name | HEART CENTERED PSYCHIATRY LLC
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Dates
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Enumeration Date | 12/11/2023
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Last Update Date | 12/11/2023
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Provider Practice Location Address
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Address Line | 3142 BRAMBLETON AVE
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City | ROANOKE
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State | VA
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Zip | 24018-3727
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Country | US
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Telephone | 540-300-5448
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Fax |
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Provider Business Mailing Address
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Address Line | 4210 ELECTRIC RD # 1127
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City | ROANOKE
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State | VA
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Zip | 24018-0728
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER MANAGER
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Name | DR. GEETA NATHAN
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Credential | MD
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Telephone | 540-300-5448
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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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