MEDICARE: NP IN FAMILY HEALTH AND PSYCHIATRY PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
2	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1588248421
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NP IN FAMILY HEALTH AND PSYCHIATRY PC

Provider Business Mailing Address
First Line	:	323 WINTHROP ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11225-3813
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	323 WINTHROP ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11225-3813
Country	:	US
Telephone Number	:	917-767-0309
Fax Number	:

Authorized Official
Title or Position	:	OFFICER
Name	:	SHAMARA ALTERNO
Credential	:
Telephone Number	:	917-767-0309

Provider Enumeration Date	:	05/06/2021
Last Update Date	:	05/06/2021

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