Healthcare Provider Details

I. General information

NPI: 1033054267
Provider Name (Legal Business Name): PERSONAL CARE NP IN FAMILY HEALTH AND PSYCHIATRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 07/19/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 W MERRICK RD STE 201D
FREEPORT NY
11520-3743
US

IV. Provider business mailing address

1731 E 46TH ST
BROOKLYN NY
11234-3606
US

V. Phone/Fax

Practice location:
  • Phone: 516-452-5867
  • Fax: 516-914-4948
Mailing address:
  • Phone: 347-834-0484
  • Fax:

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: MS. KRISTY E RICHARD
Title or Position: OWNER/NURSE PRACTITIONER
Credential: FNP-BC, PMHNP-BC
Phone: 347-834-0484