Healthcare Provider Details

I. General information

NPI: 1548165616
Provider Name (Legal Business Name): GREEN LEAF NP IN PSYCHIATRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 MAMARONECK AVE
HARRISON NY
10528-1635
US

IV. Provider business mailing address

600 MAMARONECK AVE
HARRISON NY
10528-1635
US

V. Phone/Fax

Practice location:
  • Phone: 914-704-4062
  • Fax:
Mailing address:
  • Phone: 914-704-4062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: LINDA ORJI
Title or Position: NURSE PRACTITIONER
Credential: NP
Phone: 917-704-4062