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General NPI Number Information
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NPI Number | 1033934054
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Entity Type | Organization
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Legal Business Name | IHSAN NURAH COUNSELING & MENTAL HEALTH SERVICES LLC
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Dates
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Enumeration Date | 11/15/2024
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 100 CHURCH ST RM 800
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City | NEW YORK
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State | NY
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Zip | 10007-2621
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Country | US
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Telephone | 347-968-7277
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Fax |
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Provider Business Mailing Address
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Address Line | 4309 BRISTOL STATION CT
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City | CARTERET
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State | NJ
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Zip | 07008-3163
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SAMIRA HAFIZ
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Credential | PMHNP-BC
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Telephone | 347-968-7277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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