Healthcare Provider Details

I. General information

NPI: 1932042348
Provider Name (Legal Business Name): STELLAR PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2026
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 E 169TH ST
BRONX NY
10456-1713
US

IV. Provider business mailing address

310 E 169TH ST
BRONX NY
10456-1713
US

V. Phone/Fax

Practice location:
  • Phone: 517-488-3631
  • Fax: 929-290-0328
Mailing address:
  • Phone: 517-488-3631
  • Fax: 929-290-0328

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: STELLA OKECHUKWU
Title or Position: PSYCHIATRIC NURSE PRACTITIONER
Credential: OKECHUKWU
Phone: 517-488-3631