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General NPI Number Information
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NPI Number | 1629868922
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Entity Type | Organization
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Legal Business Name | EKM NURSE PRACTITIONER IN PSYCHIATRY PLLC
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Dates
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Enumeration Date | 05/09/2025
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 311 11TH AVE
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City | NEW YORK
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State | NY
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Zip | 10001-1394
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Country | US
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Telephone | 518-703-6840
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Fax |
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Provider Business Mailing Address
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Address Line | 1178 BROADWAY FL 3 #193
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City | NEW YORK
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State | NY
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Zip | 10001-5666
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Country | US
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Telephone | 518-703-6840
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Fax | 518-613-1350
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Authorized Official
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Title or Position | OWNER
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Name | ERIN MORAN
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Credential | DNP
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Telephone | 518-703-6840
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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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