Healthcare Provider Details

I. General information

NPI: 1528994415
Provider Name (Legal Business Name): TENISHA BARTON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 JERICHO TPKE STE 117
SYOSSET NY
11791-4501
US

IV. Provider business mailing address

14358 230TH ST
LAURELTON NY
11413-3624
US

V. Phone/Fax

Practice location:
  • Phone: 718-795-7253
  • Fax:
Mailing address:
  • Phone: 718-795-7253
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2025100720
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: