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General NPI Number Information
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NPI Number | 1518775139
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Entity Type | Organization
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Legal Business Name | MIND GLOW SOLUTIONS
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Dates
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Enumeration Date | 12/28/2024
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Last Update Date | 01/19/2025
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Provider Practice Location Address
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Address Line | 307 W 38TH ST FL 16, SUITE 1617
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City | NEW YORK
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State | NY
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Zip | 10018-2913
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Country | US
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Telephone | 929-487-2874
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Fax | 201-808-2957
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Provider Business Mailing Address
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Address Line | 307 W 38TH ST FL 16, SUITE 1617
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City | NEW YORK
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State | NY
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Zip | 10018-2913
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Country | US
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Telephone | 929-487-2874
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Fax | 201-808-2957
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. JAVIER L AGET-TORRES
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Credential | DNP, PMHNP-BC
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Telephone | 929-487-2874
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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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