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General NPI Number Information
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NPI Number | 1699463190
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Entity Type | Organization
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Legal Business Name | ASTORIA MIND INC
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Dates
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Enumeration Date | 04/24/2023
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Last Update Date | 04/24/2023
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Provider Practice Location Address
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Address Line | 2001 37TH ST
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City | ASTORIA
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State | NY
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Zip | 11105-1627
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Country | US
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Telephone | 929-801-1540
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Fax |
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Provider Business Mailing Address
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Address Line | 5611 30TH AVE
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City | WOODSIDE
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State | NY
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Zip | 11377-7956
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Country | US
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Telephone | 929-801-1540
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | HASSAN IBRAHIM
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Credential | NP
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Telephone | 929-801-1540
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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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