Philadelphia Psychiatric Consultation Service

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD008370E Issued in PA

Legal business name

PHILADELPHIA PSYCHIATRIC CONSULTATION SERVICE

Practice address

191 Presidential Blvd
Suite#3W
Bala Cynwyd, PA 19004-1207

Phone

(610) 664-0948

Fax

(610) 664-0762

NPI assigned

Oct 10, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Clancy D. McKenzie, M.D.

Title

Owner

Phone

(610) 664-0948

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1191974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191974400000",
    "number": "1649468190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 PRESIDENTIAL BLVD",
            "address_2": "SUITE#3W",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041207",
            "telephone_number": "610-664-0948",
            "fax_number": "610-664-0762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 PRESIDENTIAL BLVD",
            "address_2": "SUITE#3W",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041207",
            "telephone_number": "610-664-0948",
            "fax_number": "610-664-0762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILADELPHIA PSYCHIATRIC CONSULTATION SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-10",
        "last_updated": "2007-10-10",
        "status": "A",
        "authorized_official_last_name": "MCKENZIE",
        "authorized_official_first_name": "CLANCY",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-664-0948",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD008370E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; 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.