Provider Demographics
NPI:1730220922
Name:TRIANGLE PSYCHIATRIC SERVICES, PA
Entity type:Organization
Organization Name:TRIANGLE PSYCHIATRIC SERVICES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:J
Authorized Official - Last Name:DORFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-845-1555
Mailing Address - Street 1:3909 SUNSET RIDGE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-6668
Mailing Address - Country:US
Mailing Address - Phone:919-845-1555
Mailing Address - Fax:919-845-1558
Practice Address - Street 1:3909 SUNSET RIDGE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6668
Practice Address - Country:US
Practice Address - Phone:919-845-1555
Practice Address - Fax:919-845-1558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2011-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC250142084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8928935Medicaid
NC28935OtherBLUE CROSS BLUE SHIELD
NC8928935Medicaid
C81296Medicare UPIN