Provider Demographics
NPI:1124312566
Name:SUFFOLK BEHAVIORAL MEDICINE P.C
Entity type:Organization
Organization Name:SUFFOLK BEHAVIORAL MEDICINE P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MULCHAND
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-513-6262
Mailing Address - Street 1:535 BROAD HOLLOW ROAD
Mailing Address - Street 2:SUITE B-12
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747
Mailing Address - Country:US
Mailing Address - Phone:631-513-6262
Mailing Address - Fax:
Practice Address - Street 1:535 BROADHOLLOW RD
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-3713
Practice Address - Country:US
Practice Address - Phone:631-513-6262
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-02
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2459512084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty