Healthcare Provider Details

I. General information

NPI: 1023487022
Provider Name (Legal Business Name): YENDI GABAY PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2015
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date: 12/09/2015
Reactivation Date: 02/17/2023

III. Provider practice location address

550 BROAD ST STE 606
NEWARK NJ
07102-4537
US

IV. Provider business mailing address

630 W 168TH ST
NEW YORK NY
10032-3725
US

V. Phone/Fax

Practice location:
  • Phone: 201-822-1161
  • Fax:
Mailing address:
  • Phone: 212-305-2500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF404694
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ15022200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: