MEDICARE: NASEEHA PSYCHIATRY, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568181014
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NASEEHA PSYCHIATRY, PLLC

Provider Business Mailing Address
First Line	:	5 COMPUTER DR W STE 100-01
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12205-1613
Country	:	US
Telephone Number	:	518-992-2609
Fax Number	:

Provider Business Practice Location Address
First Line	:	5 COMPUTER DR W STE 100-01
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12205-1613
Country	:	US
Telephone Number	:	518-992-2609
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. RIYAD MOHAMMED ROUF
Credential	:	MD
Telephone Number	:	518-992-2609

Provider Enumeration Date	:	08/25/2022
Last Update Date	:	08/25/2022

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