THEODORE C. BRISIMITZAKIS DO NPI 1245897859

NPI Information

NPI: 1245897859
Provider Name: THEODORE C. BRISIMITZAKIS, DO
Classification: Psychiatry & Neurology - 2084P0804X
Entity Type: Individual

Specialization: Child & Adolescent Psychiatry

PECOS Registration: Yes

Address:
501 S CHIPETA WAY
SALT LAKE CITY, UT
ZIP 84108
Phone: (801) 585-5184
Get Directions

Theodore C. Brisimitzakis, DO is a child and adolescent psychiatry psychiatry neurology in Salt Lake City, UT. The provider is child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. Theodore C. Brisimitzakis, DO NPI is 1245897859. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

501 S CHIPETA WAY
SALT LAKE CITY, UT
ZIP 84108-222
Phone: (801) 585-5184

The NPI 1245897859 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/20/2019 and was last updated on 4/7/2022.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2084P0804X	Psychiatry & Neurology	Child & Adolescent Psychiatry	12777638-1204	UTAH	Yes

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: 5/5/2024

NPI Synchronization or Removal

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