Provider Demographics
NPI:1194135871
Name:GREATER PHOENIX PSYCHIATRIC ASSOCIATE PLLC
Entity type:Organization
Organization Name:GREATER PHOENIX PSYCHIATRIC ASSOCIATE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PERVAIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:AKHTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-241-9037
Mailing Address - Street 1:9542 S DARROW DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-5120
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6530 S MAPLE AVE
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283
Practice Address - Country:US
Practice Address - Phone:602-220-6297
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-02
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty