| Psychiatry Specialities Clinics, Llc | |
|
3525 Ellicott Mills Dr Ste G Ellicott City MD 21043-4638 | |
| (410) 988-8092 | |
| (443) 420-7875 |
| Full Name | Psychiatry Specialities Clinics, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3525 Ellicott Mills Dr Ste G, Ellicott City, Maryland |
| Authorized Official Name and Position | Rinu Pradhan (OFFICE MANAGER) |
| Authorized Official Contact | 4109888092 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychiatry Specialities Clinics, Llc 3525 Ellicott Mills Dr Ellicott City MD 21043-4547 Ph: (410) 988-8092 | Psychiatry Specialities Clinics, Llc 3525 Ellicott Mills Dr Ste G Ellicott City MD 21043-4638 Ph: (410) 988-8092 |
| NPI Number | 1851864037 |
|---|---|
| Provider Enumeration Date | 01/09/2019 |
| Last Update Date | 10/10/2023 |
| Certification Date | 10/10/2023 |
| Medicare PECOS PAC ID | 8921344722 |
|---|---|
| Medicare Enrollment ID | O20190116001023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851864037 | NPI | - | NPPES |
| 345025200 | Medicaid | MD |
| Provider Name | Bikash Sharma |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841454964 PECOS PAC ID: 8527304328 Enrollment ID: I20190123000864 |
| Provider Name | Canicia Anyiatem |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932465382 PECOS PAC ID: 6103237300 Enrollment ID: I20201119000216 |
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