Healthcare Provider Details

I. General information

NPI: 1558141390
Provider Name (Legal Business Name): ELEANOR PICKERING PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2023
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1002 WESTCHESTER AVE
BRONX NY
10459-3309
US

IV. Provider business mailing address

44 W 28TH ST FL 5
NEW YORK NY
10001-4212
US

V. Phone/Fax

Practice location:
  • Phone: 718-320-4466
  • Fax:
Mailing address:
  • Phone: 212-545-2409
  • Fax: 212-463-8411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number407531
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: