Organization
CENTER FOR CHILD AND ADULT PSYCHIATRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY THORKELSON MD (PRESIDENT)
(330) 632-0172
Entity
Organization
Contact information
Practice address
2909 W BAY TO BAY BLVD STE 210, TAMPA, FL 33629-8100
(813) 995-1775
Mailing address
1911 MONONGAHELA AVE UNIT 82661, PITTSBURGH, PA 15218-6616
(330) 632-0173
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1295225597
NATIONAL PLAN & PROVIDER ENUMERATION SYSTEM
—
Enumeration date
03/03/2019
Last updated
03/03/2019
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