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General NPI Number Information
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NPI Number | 1497216675
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Entity Type | Organization
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Legal Business Name | R & V NP IN PSYCHIATRIC SERVICES PLLC
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Dates
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Enumeration Date | 03/28/2019
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Last Update Date | 09/24/2019
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Provider Practice Location Address
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Address Line | 340 TRINITY PL
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City | MALVERNE
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State | NY
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Zip | 11565-1248
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Country | US
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Telephone | 917-557-6064
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Fax | 917-591-4505
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Provider Business Mailing Address
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Address Line | 1850 LAFAYETTE AVE APT 6E
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City | BRONX
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State | NY
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Zip | 10473-2837
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Country | US
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Telephone | 646-844-0518
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | REAGAN ANUSIONWU
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Credential |
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Telephone | 718-309-0381
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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