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REVIVED SOUL MEDICAL PC NPI 1821389941


NPI Information

NPI: 1821389941
Provider Name: REVIVED SOUL MEDICAL PC
Classification: Psychiatry & Neurology - 2084P0800X
Entity Type: Organization

Specialization: Psychiatry

CLIA Number: 33D2040899

Address:
1901 AVENUE P
1A
BROOKLYN, NY
ZIP 11229
Phone: (718) 382-5060
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REVIVED SOUL MEDICAL PC is a psychiatry psychiatry neurology in Brooklyn, NY. The provider is a Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. REVIVED SOUL MEDICAL PC NPI is 1821389941. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1901 AVENUE P
1A
BROOKLYN, NY
ZIP 11229-342
Phone: (718) 382-5060

The provider's authorized official is Irina Kiblitsky .
The authorized official title is Owner and has the following contact phone number (718) 382-5060.

The CLIA number assigned to this NPI record is 33D2040899 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/23/2011 and was last updated on 4/23/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12084P0800XPsychiatry & NeurologyPsychiatry246958NEW YORKYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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