Provider Demographics
NPI:1487958559
Name:INTERFAITH PSYCHIATRY SERVICES, P.C.
Entity type:Organization
Organization Name:INTERFAITH PSYCHIATRY SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN / P.C. PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:HERSHBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-613-4969
Mailing Address - Street 1:1545 ATLANTIC AVENUE
Mailing Address - Street 2:FACULTY PRACTICE
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238
Mailing Address - Country:US
Mailing Address - Phone:718-613-4708
Mailing Address - Fax:718-613-4101
Practice Address - Street 1:1545 ATLANTIC AVENUE
Practice Address - Street 2:FACULTY PRACTICE
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-1122
Practice Address - Country:US
Practice Address - Phone:718-240-8352
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-05
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty