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General NPI Number Information
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NPI Number | 1043953060
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Entity Type | Organization
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Legal Business Name | BROOKLYN NP IN PSYCHIATRY PLLC
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Dates
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Enumeration Date | 04/18/2022
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Last Update Date | 04/18/2022
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Provider Practice Location Address
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Address Line | 1131 E 103RD
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City | BROOKLYN
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State | NY
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Zip | 11236
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Country | US
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Telephone | 347-991-1185
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Fax | 347-894-5021
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Provider Business Mailing Address
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Address Line | 2918 AVENUE I
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City | BROOKLYN
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State | NY
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Zip | 11210-2935
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Country | US
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Telephone | 347-991-1185
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Fax | 347-894-5021
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MARGARETTE DESSOURCES
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Credential | DNP
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Telephone | 347-991-1185
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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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