MEDICARE: SOMA NURSE PRACTITIONER IN PSYCHIATRY PLLC

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

General Provider Information

NPI Number	:	1912863655
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOMA NURSE PRACTITIONER IN PSYCHIATRY PLLC

Provider Business Mailing Address
First Line	:	118 ASPEN DR
Second Line	:
City	:	MILFORD
State	:	PA
Zip	:	18337-7455
Country	:	US
Telephone Number	:	917-544-9607
Fax Number	:	718-962-7585

Provider Business Practice Location Address
First Line	:	386 E 161ST ST APT 2C
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10451-4100
Country	:	US
Telephone Number	:	917-544-9607
Fax Number	:	718-962-7585

Authorized Official
Title or Position	:	NURSE PRACTITIONER IN PSYCHIATRY
Name	:	MS. JHANNA M FRANCISCO REYES
Credential	:	PMHNP
Telephone Number	:	917-544-9607

Provider Enumeration Date	:	12/26/2025
Last Update Date	:	01/29/2026

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