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General NPI Number Information
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NPI Number | 1528959632
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Entity Type | Organization
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Legal Business Name | PEACEFUL SWAN INTEGRATIVE PSYCHIATRY NP IN PSYCHIATRY PLLC
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Dates
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Enumeration Date | 07/15/2025
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 397 BRIDGE ST
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City | BROOKLYN
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State | NY
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Zip | 11201
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Country | US
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Telephone | 475-441-3924
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Fax |
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Provider Business Mailing Address
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Address Line | 1080 OLD COUNTRY RD # 1118
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City | WESTBURY
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State | NY
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Zip | 11590-5625
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Country | US
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Telephone | 475-441-3924
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | OLANIKE O KEKERE
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Credential | NP
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Telephone | 309-281-9117
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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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