Modern Psychiatric Services, P.C.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

197511 Issued in NY

Legal business name

MODERN PSYCHIATRIC SERVICES, P.C.

Practice address

8747 Bay Pkwy
Brooklyn, NY 11214-5159

Phone

(718) 259-8582

NPI assigned

Feb 16, 2009

Organization subpart

No

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

Authorized official

Name

Ms. Alexandra Shereshevskaya, MD

Title

Owner

Phone

(718) 259-8582

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1234742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234742400000",
    "number": "1215176250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8747 BAY PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112145159",
            "telephone_number": "718-259-8582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8747 BAY PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112145159",
            "telephone_number": "718-259-8582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN PSYCHIATRIC SERVICES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-16",
        "last_updated": "2009-02-16",
        "status": "A",
        "authorized_official_last_name": "SHERESHEVSKAYA",
        "authorized_official_first_name": "ALEXANDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-259-8582",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "197511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01420795",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2009; 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.