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General NPI Number Information
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NPI Number | 1568395093
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Entity Type | Organization
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Legal Business Name | BRONX INTEGRATIVE CARE NP IN FAMILY HEALTH PLLC
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Dates
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Enumeration Date | 06/04/2026
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Last Update Date | 06/04/2026
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Provider Practice Location Address
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Address Line | 638 E 169TH ST FRNT 2
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City | BRONX
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State | NY
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Zip | 10456-2411
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Country | US
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Telephone | 917-916-9322
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Fax |
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Provider Business Mailing Address
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Address Line | 638 E 169TH ST FRNT 2
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City | BRONX
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State | NY
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Zip | 10456-2411
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Country | US
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Telephone | 917-916-9322
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RAUL ALEJANDRO HERRERA IZQUIERDO
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Credential | FNP-BC ,CMGT-BC
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Telephone | 917-916-9322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral 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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #6
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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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Taxonomy #7
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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