Waterbury Psychiatric Associates, P.C.

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

042814 Issued in CT

Legal business name

WATERBURY PSYCHIATRIC ASSOCIATES, P.C.

Practice address

133 Scovill St
Suite # 201
Waterbury, CT 06706-1127

Phone

(203) 597-0575

Fax

(203) 757-4105

NPI assigned

Apr 12, 2007

Last updated

Aug 22, 2020By 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

Azhar Imam, M.D.NPI 1578516597

Title

President

Phone

(203) 597-0575

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Azhar Imam, MD

  • Psychiatry Physician
  • Fairfax, VA
  • NPI 1578516597
  NPD (past) Authorized official

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316161193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 SCOVILL ST",
            "address_2": "SUITE # 201",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067061127",
            "telephone_number": "203-597-0575",
            "fax_number": "203-757-4105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 SCOVILL ST",
            "address_2": "SUITE # 201",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067061127",
            "telephone_number": "203-597-0575",
            "fax_number": "203-757-4105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERBURY PSYCHIATRIC ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "IMAM",
        "authorized_official_first_name": "AZHAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-597-0575",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "CT",
            "license": "042814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Waterbury Podiatry Consultants
• Waterbury Pulmonary Associates
• Waterbury Radiation Oncology Associates, PC (Waterbury Radiation Oncology Associates)
• Melanie A. Watkins-Griffin, LCSW
• Frederick J. Watson, M.D.
• Montel Watson

• Adult Mental Health Clinic/Center in Waterbury, CT
• Providers in Waterbury, CT by specialty
• Adult Mental Health Clinic/Center in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.