Organization
GWINNETT PSYCHIATRY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NASIRA RUBINA M.D. (PRESIDENT)
(678) 749-6063
Entity
Organization
Contact information
Practice address
170 CAMDEN HILL RD, SUITE C, LAWRENCEVILLE, GA 30046-7418
(678) 226-2295
(678) 226-2296
Mailing address
170 CAMDEN HILL RD, SUITE C, LAWRENCEVILLE, GA 30046-7418
(678) 226-2295
(678) 226-2296
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
056642
GA
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
056642
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10068469
—
GA
05
—
648074039A
—
GA
Enumeration date
03/09/2007
Last updated
06/06/2012
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