Healthcare Provider Details

I. General information

NPI: 1205768561
Provider Name (Legal Business Name): KALEDISCOPE NP IN FAMILY HEALTH AND PSYCHIATRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

846 DEAN DRIVE
BALDWIN NY
11510
US

IV. Provider business mailing address

846 DEAN DR
NORTH BALDWIN NY
11510-1109
US

V. Phone/Fax

Practice location:
  • Phone: 516-543-3935
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KRISTLE LEE SIMMS-MURPHY
Title or Position: OWNER
Credential: NP
Phone: 347-612-1575