Center for Mind Brain & Behavioral Medicine,Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

35079074M Issued in OH

Legal business name

CENTER FOR MIND BRAIN & BEHAVIORAL MEDICINE,INC

Practice address

4825 Higbee Ave NW
Suite 102
Canton, OH 44718-2567

Phone

(330) 453-9085

Fax

(330) 453-9089

NPI assigned

Oct 3, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Shishuka Maholtra, MD

Title

Physician/Owner

Phone

(330) 453-9085

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1222992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222992000000",
    "number": "1841441284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4825 HIGBEE AVE NW",
            "address_2": "SUITE 102",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182567",
            "telephone_number": "330-453-9085",
            "fax_number": "330-453-9089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4825 HIGBEE AVE NW",
            "address_2": "SUITE 102",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182567",
            "telephone_number": "330-453-9085",
            "fax_number": "330-453-9089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR MIND BRAIN & BEHAVIORAL MEDICINE,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-03",
        "last_updated": "2008-10-03",
        "status": "A",
        "authorized_official_last_name": "MAHOLTRA",
        "authorized_official_first_name": "SHISHUKA",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "330-453-9085",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "OH",
            "license": "35079074M",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Canton, OH
• Providers in Canton, OH by specialty
• Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2008; 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.