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General NPI Number Information
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NPI Number | 1477166585
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Entity Type | Organization
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Legal Business Name | NURSE PRACTITIONER PSYCHIATRY & PSYCHOLOGY SERVICES, PLLC
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Dates
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Enumeration Date | 08/28/2020
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Last Update Date | 08/28/2020
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Provider Practice Location Address
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Address Line | 310 E SHORE RD STE 100
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City | GREAT NECK
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State | NY
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Zip | 11023-2432
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Country | US
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Telephone | 516-466-2636
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Fax | 516-464-0203
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Provider Business Mailing Address
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Address Line | 310 E SHORE RD STE 100
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City | GREAT NECK
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State | NY
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Zip | 11023-2432
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Country | US
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Telephone | 516-466-2636
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Fax | 516-464-0203
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Authorized Official
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Title or Position | OWNER
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Name | DR. HOWARD ROMBOM
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Credential | PH.D.
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Telephone | 516-466-2636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TH0100X
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Taxonomy Name | Health Service Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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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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