KETAMINE TREATMENT CENTERS OF PRINCETON, LLC (NPI# 1780174482) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780174482 |
| Entity Type | Organization |
| Organization Name | KETAMINE TREATMENT CENTERS OF PRINCETON, LLC |
| Other Organization Name | ACTIFY NEUROTHERAPIES MEDICAL |
| Practice Address |
12 E 44th St Fl 6 New York NY 10017-3624 |
| Mailing Address |
800 Bunn Dr Ste 304 Princeton NJ 08540-1968 |
| Practice Telephone | 8885668774 |
| Mailing Telephone | 6096514429 |
| Enumeration Date | 2018-05-17 |
| Last Update Date | 2018-05-17 |
| Authorized Official Name | STEVEN P. LEVINE (OWNER) |
| Authorized Official Telephone | 6096514429 |
| Is Organization Subpart | Y |
| Parent Organization Name | KETAMINE TREATMENT CENTERS OF PRINCETON, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Actify Neurotherapies Medical | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679119994 | Ketamine Treatment Centers of Princeton, LLC | Psychiatry & Neurology | 9800 Falls Rd Ste 105, Potomac, MD 20854-3939 | 2019-11-21 |
| 1538705835 | Ketamine Treatment Centers of Princeton, LLC | Psychiatry & Neurology | 357 S Gulph Rd Ste 260, King of Prussia, PA 19406-3174 | 2019-11-21 |
| 1730725052 | Ketamine Treatment Centers of Princeton, LLC | Psychiatry & Neurology | 91 S Jefferson Rd Ste 301, Whippany, NJ 07981-1037 | 2019-11-21 |
| 1174169478 | Ketamine Treatment Centers of Princeton, LLC | Psychiatry & Neurology | 1122 Kenilworth Dr Ste 418, Towson, MD 21204-2148 | 2019-11-21 |
| 1114563434 | Ketamine Treatment Centers of Princeton, LLC | Psychiatry & Neurology | 1411 N Flagler Dr Ste 4700, West Palm Beach, FL 33401-3408 | 2019-11-21 |
| 1609288604 | Ketamine Treatment Centers of Princeton, LLC | Psychiatry & Neurology | 800 Bunn Dr, Suite 304, Princeton, NJ 08540-1968 | 2014-05-24 |
| Street Address |
12 E 44TH ST FL 6 |
| City | NEW YORK |
| State | NY |
| Zip Code | 10017-3624 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700424702 | Amanda Arielle Grannum | Social Worker | 227 E 41st Street, New York, NY 10017 | 2019-12-20 |
| 1205399748 | Jasmine Marie Williams | Social Worker | Comprehensive Therapeutic Services, 450 Lexington Ave, Fourth Floor, New York, NY 10017 | 2019-04-11 |
| 1093208415 | Kaylin Salubro | Nurse Practitioner | 18 E 41st St Fl 12, New York, NY 10017 | 2018-06-11 |
| 1932698792 | Bryan Cordes | Social Worker | 295 Madison Avenue, Suite 707, New York, NY 10017 | 2018-05-08 |
| 1376048173 | Matthew Bernstein, M.d. Pllc | Psychiatry & Neurology | 370 Lexington Avenue, Suite 1001, New York, NY 10017 | 2018-03-26 |
| 1285137430 | Midtown East Podiatry and Foot Surgery L.L.C. | Podiatrist | 230 E 48th St., #1b, New York, NY 10017 | 2018-03-14 |
| 1831692136 | Olga S Pankiv | Nurse Practitioner | 545 5th Avenue Suite 817, 545 5th Avenue Suite 817, New York, NY 10017 | 2018-03-13 |
| 1023523198 | Randa Jaafar Md,pc | Pain Medicine | 340 East 49th St., Ground Floor, New York, NY 10017 | 2017-12-11 |
| 1962912154 | Yonatan Moshe Sobin | Psychologist | 370 Lexington Ave Rm 1000, New York, NY 10017 | 2017-10-03 |
| 1558880344 | Jendayi Polite | Counselor | 100 Park Ave Fl 16, New York, NY 10017 | 2017-09-13 |
| Find all providers in zip 10017 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| 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. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
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|---|---|---|---|---|
| 1447850276 | Nyc Psychiatric Associates | Psychiatry & Neurology | 385 5th Ave Rm 1106, New York, NY 10016-3340 | 2020-10-30 |
| 1730706169 | Scott Dibartolo | Psychiatry & Neurology | 426 W 45th St Apt 5fe, New York, NY 10036-9066 | 2020-07-01 |
| 1104449701 | Clear Minds Nyc, LLC | Psychiatry & Neurology | 210 E 121st St Apt 2m, New York, NY 10035-3053 | 2020-05-19 |
| 1215556774 | Allexian, LLC | Psychiatry & Neurology | 418 E 71st St Ph Fl, New York, NY 10021-4894 | 2020-04-14 |
| 1427682350 | Brian Francis Esposito | Psychiatry & Neurology | 435 E 70th St Apt 27h, New York, NY 10021-5349 | 2020-02-29 |
| 1255979902 | Yuli Fradkin Md LLC | Psychiatry & Neurology | 315 W 57th St Ste 401, New York, NY 10019-3147 | 2019-12-12 |
| 1477196822 | Martijn Figee | Psychiatry & Neurology | 1000 10th Ave # 10g-44, New York, NY 10019-1147 | 2019-10-17 |
| 1033750823 | Mccd Psychiatry Services Pllc | Psychiatry & Neurology | 109 W 27th St # 5s, New York, NY 10001-6208 | 2019-10-02 |
| 1366093783 | James Halper Md | Psychiatry & Neurology | 41 W 72nd Street, 1c, New York, NY 10023-3476 | 2019-09-26 |
| 1891349635 | Veerle Bergink | Psychiatry & Neurology | 1425 Madison Ave # L4-34, New York, NY 10029-6514 | 2019-07-30 |
| Find all providers in NEW YORK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.