MEDICARE: MANHATTAN PSY.CTR

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	283Q00000X	Psychiatric Hospital	29799	NY

General Provider Information

NPI Number	:	1770717100
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MANHATTAN PSY.CTR

Provider Business Mailing Address
First Line	:	346 MERCER LOOP
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07302-3235
Country	:	US
Telephone Number	:	646-672-6474
Fax Number	:	646-672-6484

Provider Business Practice Location Address
First Line	:	346 MERCER LOOP
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07302-3235
Country	:	US
Telephone Number	:	646-672-6474
Fax Number	:	646-672-6484

Authorized Official
Title or Position	:	STAFF
Name	:	MR. SIRAJ D BAIG
Credential	:	PHARMACIST
Telephone Number	:	646-672-6474

Provider Enumeration Date	:	05/13/2009
Last Update Date	:	05/13/2009

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