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General NPI Number Information
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NPI Number | 1336745058
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE WELLNESS NURSE PRACTITIONER IN PSYCHIATRY PLLC
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Dates
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Enumeration Date | 12/08/2020
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 157 E 86TH ST STE 4
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City | NEW YORK
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State | NY
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Zip | 10028-2175
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Country | US
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Telephone | 718-790-4511
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Fax | 646-809-8707
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Provider Business Mailing Address
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Address Line | 169 MADISON AVE STE 38577
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City | NEW YORK
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State | NY
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Zip | 10016-5101
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Country | US
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Telephone | 718-790-4511
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Fax | 646-809-8707
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Authorized Official
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Title or Position | EXECUTIVE ASSOCIATE
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Name | CLAUDIA MC BRIDE
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Credential |
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Telephone | 914-850-2593
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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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