Healthcare Provider Details
I. General information
NPI: 1861315400
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
243 TRESSER BLVD
STAMFORD CT
06901-3436
US
V. Phone/Fax
- Phone: 914-764-2954
- Fax:
- Phone: 914-764-2954
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
KRISTOFER
GENERALES
Title or Position: CO-FOUNDER
Credential: DNP, PMHNP-BC
Phone: 914-413-2324