Healthcare Provider Details

I. General information

NPI: 1073452264
Provider Name (Legal Business Name): LATARA TAYLOR NP IN PSYCHIATRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 E EVERGREEN RD STE 123
NEW CITY NY
10956-5145
US

IV. Provider business mailing address

11 W PROSPECT AVE STE 3D
MOUNT VERNON NY
10550-2017
US

V. Phone/Fax

Practice location:
  • Phone: 914-407-3426
  • Fax:
Mailing address:
  • Phone:
  • 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: LATARA TAYLOR
Title or Position: CEO
Credential: NP
Phone: 914-407-3426