Behavioral Health Medical Practice P.C.

Primary specialty

SpecialistTaxonomy code 174400000X

License

227462 Issued in NY

Legal business name

BEHAVIORAL HEALTH MEDICAL PRACTICE P.C.

Practice address

240 Patchogue Yaphank Rd
Suite 211
East Patchogue, NY 11772-4868

Phone

(631) 758-2815

Fax

(631) 206-9299

NPI assigned

Apr 9, 2007

Last updated

Aug 20, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Moataz Yousef Haggag, M.D.NPI 1508966565

Title

President

Phone

(631) 758-2815

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Moataz Yousef Haggag, M.D.

  • Psychiatry Physician
  • East Patchogue, NY
  • NPI 1508966565

  Specialist

  Medicare reassignment NPD Authorized official
• Joanne M Della Valle, LCSW

  • Clinical Social Worker
  • East Patchogue, NY
  • NPI 1649648635
  Medicare reassignment NPD
• Pamela Kissoondhan

  • Psychiatric/Mental Health Nurse Practitioner
  • Brentwood, NY
  • NPI 1881053981
  NPD (past)
• Fahim U Qureshi, MD

  • Child & Adolescent Psychiatry Physician
  • Brooklyn, NY
  • NPI 1093785297
  NPD (past)
• Sharon Fay Solina, LCSW

  • Clinical Social Worker
  • Patchogue, NY
  • NPI 1972701886
  NPD (past)

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629417600000",
    "number": "1033232467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 FIG DR",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117465657",
            "telephone_number": "631-758-2815",
            "fax_number": "631-206-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 PATCHOGUE YAPHANK RD",
            "address_2": "SUITE 211",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724868",
            "telephone_number": "631-758-2815",
            "fax_number": "631-206-9299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEHAVIORAL HEALTH MEDICAL PRACTICE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-20",
        "status": "A",
        "authorized_official_last_name": "HAGGAG",
        "authorized_official_first_name": "MOATAZ",
        "authorized_official_middle_name": "YOUSEF",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-758-2815",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "227462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02986065",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Basant, MD
• Jessica Bass, LPN
• Karen L Bath, ATC
• Audrey Annmarie Beckford, LPN
• Rebecka Abigail Beckles
• David Belli, OT
• Marion J Bergman, MD
• Hasan I Berisha, M.D,
• Richard E Berman, M.D.
• Gopal A Bhandarkar, M.D.

• Specialist in East Patchogue, NY
• Providers in East Patchogue, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.