Healthcare Provider Details

I. General information

NPI: 1386570745
Provider Name (Legal Business Name): JENNIFER WINIARCZYK-NALLE, NP IN PSYCHIATRY, RN, MSN, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5655 STEVENS DR S
CICERO NY
13039-9535
US

IV. Provider business mailing address

5655 STEVENS DR S
CICERO NY
13039-9535
US

V. Phone/Fax

Practice location:
  • Phone: 631-380-3630
  • Fax: 315-784-4288
Mailing address:
  • Phone: 631-380-3630
  • Fax: 315-784-4288

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: JENNIFER WINIARCZYK-NALLE
Title or Position: OWNER
Credential: PNP, PMHNP-BC
Phone: 631-380-3630