Provider Demographics
NPI:1386991826
Name:SUNSHINE PSYCHIATRIC SERVICES INC
Entity type:Organization
Organization Name:SUNSHINE PSYCHIATRIC SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAHBOOB
Authorized Official - Middle Name:AHMAD
Authorized Official - Last Name:ASLAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-980-7926
Mailing Address - Street 1:105 WEST RD
Mailing Address - Street 2:
Mailing Address - City:ELLINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06029-5700
Mailing Address - Country:US
Mailing Address - Phone:860-871-5402
Mailing Address - Fax:860-871-5413
Practice Address - Street 1:105 WEST RD
Practice Address - Street 2:
Practice Address - City:ELLINGTON
Practice Address - State:CT
Practice Address - Zip Code:06029-5700
Practice Address - Country:US
Practice Address - Phone:860-871-5402
Practice Address - Fax:860-871-5413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-14
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT047643261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)