Healthcare Provider Details

I. General information

NPI: 1831498294
Provider Name (Legal Business Name): NATALYA GORYUNOVA M.D., PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2011
Last Update Date: 09/13/2024
Certification Date: 09/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 WASHINGTON RD
WEST POINT NY
10996-1109
US

IV. Provider business mailing address

900 WASHINGTON RD
WEST POINT NY
10996-1109
US

V. Phone/Fax

Practice location:
  • Phone: 845-938-3441
  • Fax: 877-874-1027
Mailing address:
  • Phone: 845-938-3441
  • Fax: 877-874-1027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberF403985-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: