Healthcare Provider Details

I. General information

NPI: 1144195439
Provider Name (Legal Business Name): ESTHER OTU-NYARKO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2025
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1347 NORTH AVE
NEW ROCHELLE NY
10804-2122
US

IV. Provider business mailing address

1347 NORTH AVE
NEW ROCHELLE NY
10804-2122
US

V. Phone/Fax

Practice location:
  • Phone: 860-933-6800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number968440-01
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License Number968440-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: