Healthcare Provider Details

I. General information

NPI: 1033958160
Provider Name (Legal Business Name): AFIFA MEHMOOD PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2024
Last Update Date: 10/11/2026
Certification Date: 10/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9332 91ST AVE
WOODHAVEN NY
11421-2739
US

IV. Provider business mailing address

9332 91ST AVE
WOODHAVEN NY
11421-2739
US

V. Phone/Fax

Practice location:
  • Phone: 702-460-3321
  • Fax:
Mailing address:
  • Phone: 702-460-3321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number408963
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: