Provider Demographics
NPI:1679792345
Name:AFFILIATES IN PSYCHIATRY, PA
Entity type:Organization
Organization Name:AFFILIATES IN PSYCHIATRY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PRAFUL
Authorized Official - Middle Name:C
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:302-738-7040
Mailing Address - Street 1:PO BOX 5376
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-0376
Mailing Address - Country:US
Mailing Address - Phone:302-738-7040
Mailing Address - Fax:302-738-7042
Practice Address - Street 1:260 CHAPMAN RD STE 100C
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5410
Practice Address - Country:US
Practice Address - Phone:302-738-7040
Practice Address - Fax:302-738-7042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-00016702084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000157101Medicaid
DEFO4109Medicare UPIN
DE123395Medicare PIN