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General NPI Number Information
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NPI Number | 1467002204
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Entity Type | Organization
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Legal Business Name | NY PEDIATRIC PSYCHIATRY PLLC
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Dates
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Enumeration Date | 09/13/2019
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Last Update Date | 09/13/2019
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Provider Practice Location Address
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Address Line | 233 7TH ST STE OFFICE9
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City | GARDEN CITY
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State | NY
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Zip | 11530-5747
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Country | US
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Telephone | 917-244-6963
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Fax |
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Provider Business Mailing Address
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Address Line | 233 7TH ST STE OFFICE9
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City | GARDEN CITY
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State | NY
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Zip | 11530-5747
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Country | US
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Telephone | 917-244-6963
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SANIYA KIBRIA
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Credential | MD
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Telephone | 914-643-1229
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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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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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