Triangle Forensic Neuropsychiatry, PLLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

TRIANGLE FORENSIC NEUROPSYCHIATRY, PLLC

Practice address

4700 Falls of Neuse Rd
Suite 250
Raleigh, NC 27609-6200

Phone

(919) 906-0868

NPI assigned

Dec 2, 2012

Organization subpart

No

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

Authorized official

Name

Manish Amrish Fozdar, MDNPI 1497751143

Title

President

Phone

(919) 906-0868

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Manish Amrish Fozdar, M.D.

  • Psychiatry Physician
  • Raleigh, NC
  • NPI 1497751143
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1354406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354406400000",
    "number": "1073858080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 FALLS OF NEUSE RD",
            "address_2": "SUITE 250",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096200",
            "telephone_number": "919-906-0868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 FALLS OF NEUSE RD",
            "address_2": "SUITE 250",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096200",
            "telephone_number": "919-906-0868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIANGLE FORENSIC NEUROPSYCHIATRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-02",
        "last_updated": "2012-12-02",
        "status": "A",
        "authorized_official_last_name": "FOZDAR",
        "authorized_official_first_name": "MANISH",
        "authorized_official_middle_name": "AMRISH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-906-0868",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Psychiatry Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2012; 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.