Child and Adult Clinical Psychiatry PC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

CHILD AND ADULT CLINICAL PSYCHIATRY PC

Practice address

75 Prospect St Ste 110
Huntington, NY 11743-3320

Phone

(631) 223-7739

Fax

(855) 225-9703

NPI assigned

Jun 4, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Aleksandra Krunic, MD

Title

Medical Director

Phone

(631) 223-7739

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1591228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591228800000",
    "number": "1023632015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 PROSPECT ST STE 110",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117433320",
            "telephone_number": "631-223-7739",
            "fax_number": "855-225-9703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 PROSPECT ST STE 110",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117433320",
            "telephone_number": "631-223-7739",
            "fax_number": "855-225-9703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILD AND ADULT CLINICAL PSYCHIATRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-04",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A",
        "authorized_official_last_name": "KRUNIC",
        "authorized_official_first_name": "ALEKSANDRA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "631-223-7739",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD LICENSE",
            "identifier": "258783",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Huntington, NY
• Providers in Huntington, NY by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.