Healthcare Provider Details

I. General information

NPI: 1194642017
Provider Name (Legal Business Name): ANDRIY ALEKSEYEV MSN, APRN, PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 QUALITY ST STE 69
TRUMBULL CT
06611-7700
US

IV. Provider business mailing address

50 QUALITY ST STE 69
TRUMBULL CT
06611-7700
US

V. Phone/Fax

Practice location:
  • Phone: 914-306-2191
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number408818
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: