Healthcare Provider Details

I. General information

NPI: 1912627548
Provider Name (Legal Business Name): JOANN PAOLETTI PHD PSYCHIATRIC NURSE PRACTITIONER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2022
Last Update Date: 09/01/2022
Certification Date: 09/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 LUKE CT
STATEN ISLAND NY
10306-1154
US

IV. Provider business mailing address

49 LUKE CT
STATEN ISLAND NY
10306-1154
US

V. Phone/Fax

Practice location:
  • Phone: 646-207-6260
  • Fax:
Mailing address:
  • Phone: 646-207-6260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOANN PALOETTI
Title or Position: OWNER
Credential:
Phone: 646-207-6260