Provider Demographics
NPI:1912260977
Name:SACHDEV PSYCHIATRIC SERVICES, P.L.
Entity type:Organization
Organization Name:SACHDEV PSYCHIATRIC SERVICES, P.L.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SACHDEV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-319-2120
Mailing Address - Street 1:860 CENTURY MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32796-2141
Mailing Address - Country:US
Mailing Address - Phone:321-267-8260
Mailing Address - Fax:321-267-5106
Practice Address - Street 1:860 CENTURY MEDICAL DR
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32796-2141
Practice Address - Country:US
Practice Address - Phone:321-267-8260
Practice Address - Fax:321-267-5106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-24
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty