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General NPI Number Information
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NPI Number | 1598793150
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Entity Type | Organization
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Legal Business Name | SOUTHAMPTON PSYCHIATRIC (NP) SERVICES, PLLC
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 10/04/2013
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Provider Practice Location Address
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Address Line | 244 5TH AVE SUITE 1422
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City | NEW YORK
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State | NY
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Zip | 10001-7604
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Country | US
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Telephone | 631-766-5295
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Fax |
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Provider Business Mailing Address
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Address Line | 1140 RUSSELL LOOP
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City | THE VILLAGES
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State | FL
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Zip | 32162-6459
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Country | US
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Telephone | 631-766-5295
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CELIA NACCARATO
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Credential | PHD, PMHNP-BC
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Telephone | 631-766-5295
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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 | F400920-1
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License Number State | NY
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