Healthcare Provider Details

I. General information

NPI: 1023896180
Provider Name (Legal Business Name): KYLE J ARNOLD PMHNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2023
Last Update Date: 10/04/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 GREENFIELD PKWY STE 115
LIVERPOOL NY
13088-6566
US

IV. Provider business mailing address

370 VIOLET AVE
POUGHKEEPSIE NY
12601-1034
US

V. Phone/Fax

Practice location:
  • Phone: 845-471-1807
  • Fax:
Mailing address:
  • Phone: 845-471-1807
  • Fax: 845-471-1815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number405317
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: