Provider Demographics
NPI:1033928262
Name:MAVERICK PSYCHIATRY
Entity type:Organization
Organization Name:MAVERICK PSYCHIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:JANIK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:917-244-6000
Mailing Address - Street 1:10555 ACACIA PARK PL
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89135-1243
Mailing Address - Country:US
Mailing Address - Phone:917-244-0000
Mailing Address - Fax:
Practice Address - Street 1:6415 S FORT APACHE RD STE 1851004
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-6744
Practice Address - Country:US
Practice Address - Phone:702-530-7069
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-02
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty