Healthcare Provider Details

I. General information

NPI: 1013675396
Provider Name (Legal Business Name): KULJIT MANN PSYCHIATRIC NP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2021
Last Update Date: 08/09/2023
Certification Date: 08/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

347 5TH AVE RM 1402
NEW YORK NY
10016-5034
US

IV. Provider business mailing address

347 5TH AVE RM 1402
NEW YORK NY
10016-5034
US

V. Phone/Fax

Practice location:
  • Phone: 929-810-4645
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: KULJIT MANN
Title or Position: FOUNDER
Credential: PMHNP
Phone: 929-810-4645