Healthcare Provider Details

I. General information

NPI: 1760305429
Provider Name (Legal Business Name): ASTRA PSYCHIATRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 WESTCHESTER AVE STE N641
RYE BROOK NY
10573-1360
US

IV. Provider business mailing address

24 LEWIS RD
STAMFORD CT
06905-2213
US

V. Phone/Fax

Practice location:
  • Phone: 914-764-2954
  • Fax: 914-259-5363
Mailing address:
  • Phone: 914-764-2954
  • Fax: 914-259-5363

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: KRISTOFER GENERALES
Title or Position: OWNER
Credential: NP
Phone: 914-764-2954