NPIMap

Organization Active NPI

Ketamine Treatment Centers of Princeton, LLC

  • Psychiatry Physician
  • New York, NY
National Provider Identifier
1780174482
Registry record updated May 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
KETAMINE TREATMENT CENTERS OF PRINCETON, LLC
Practice address
12 E 44TH St FL 6
New York, NY 10017-3624
Phone
(888) 566-8774
NPI assigned
May 17, 2018
Organization subpart
Yes
Parent organization
KETAMINE TREATMENT CENTERS OF PRINCETON, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 17, 2018

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

Authorized official

Name
Steven P. Levine
Title
Owner
Phone
(609) 651-4429

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

12 E 44TH St FL 6
New York, NY 10017-3624

Mailing address

800 Bunn Dr Ste 304
Princeton, NJ 08540-1968
Phone (609) 651-4429

Other names 1

  • Actify Neurotherapies Medical Doing business as

National Provider Directory

National Provider Directory
Part of
Ketamine Treatment Centers of Princeton LLC

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1526515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526515200000",
    "number": "1780174482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 BUNN DR STE 304",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085401968",
            "telephone_number": "609-651-4429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 E 44TH ST FL 6",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100173624",
            "telephone_number": "888-566-8774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KETAMINE TREATMENT CENTERS OF PRINCETON, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KETAMINE TREATMENT CENTERS OF PRINCETON, LLC",
        "enumeration_date": "2018-05-17",
        "last_updated": "2018-05-17",
        "status": "A",
        "authorized_official_last_name": "LEVINE",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "609-651-4429"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Actify Neurotherapies Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2018; 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.