Healthcare Provider Details

I. General information

NPI: 1871424622
Provider Name (Legal Business Name): PAUL HAN NP IN PSYCHIATRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8268 164TH ST
QUEENS NY
11432
US

IV. Provider business mailing address

20934 NORTHERN BLVD # 1078
BAYSIDE NY
11361-3149
US

V. Phone/Fax

Practice location:
  • Phone: 718-883-3000
  • 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: PAUL HAN
Title or Position: OWNER
Credential: NP
Phone: 718-883-3000