Healthcare Provider Details

I. General information

NPI: 1770439606
Provider Name (Legal Business Name): PAMITA NILA BAKSH PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/04/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

667 STONELEIGH AVE STE 202
CARMEL NY
10512-2455
US

IV. Provider business mailing address

100 CHURCH ST
NEW YORK NY
10007-2601
US

V. Phone/Fax

Practice location:
  • Phone: 845-279-5908
  • Fax: 845-622-5055
Mailing address:
  • Phone: 212-801-6000
  • Fax: 212-801-3250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF407969
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: