Healthcare Provider Details

I. General information

NPI: 1811891864
Provider Name (Legal Business Name): CONFLUENCE NP IN PSYCHIATRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 NORTH COUNTY ROAD SUITE 205
MOUNT SINAI NY
11766
US

IV. Provider business mailing address

28 NORTH COUNTY ROAD SUITE 205
MOUNT SINAI NY
11766
US

V. Phone/Fax

Practice location:
  • Phone: 580-341-0027
  • Fax: 718-691-7734
Mailing address:
  • Phone: 580-341-0027
  • Fax: 718-691-7734

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: PROMISE TIMILEHIN AWE
Title or Position: OWNER
Credential: NP
Phone: 580-341-0027