Provider Demographics
NPI:1396338414
Name:ADVANCED TREATMENT LLC
Entity type:Organization
Organization Name:ADVANCED TREATMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SIBTAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-371-8855
Mailing Address - Street 1:14 ADAMS CT
Mailing Address - Street 2:
Mailing Address - City:MAHWAH
Mailing Address - State:NJ
Mailing Address - Zip Code:07430-3197
Mailing Address - Country:US
Mailing Address - Phone:646-371-8855
Mailing Address - Fax:
Practice Address - Street 1:230 E RIDGEWOOD AVE BUILDING 6, 2ND FLOOR
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-4142
Practice Address - Country:US
Practice Address - Phone:551-237-4987
Practice Address - Fax:201-967-4182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-19
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center