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General NPI Number Information
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NPI Number | 1326416199
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Entity Type | Organization
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Legal Business Name | NEW LIFE PSYCHIATRY COUNSELING SERVICE
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Dates
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Enumeration Date | 09/09/2015
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Last Update Date | 09/09/2015
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Provider Practice Location Address
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Address Line | 7127 FRESH POND RD FIRST FLOOR RIGHT
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City | RIDGEWOOD
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State | NY
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Zip | 11385-5918
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Country | US
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Telephone | 718-381-2829
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Fax | 718-381-2819
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Provider Business Mailing Address
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Address Line | 7127 FRESH POND RD FIRST FLOOR RIGHT
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City | RIDGEWOOD
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State | NY
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Zip | 11385-5918
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Country | US
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Telephone | 718-381-2829
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Fax | 718-381-2819
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. IMRAN AZIZ SHAIKH
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Credential | MD
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Telephone | 917-403-6271
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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 | 264908
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License Number State | NY
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