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General NPI Number Information
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NPI Number | 1720602691
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Entity Type | Organization
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Legal Business Name | CHUKWUKA S MORDI, NP PSYCHIATRY PC
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Dates
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Enumeration Date | 06/05/2020
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Last Update Date | 06/05/2020
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Provider Practice Location Address
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Address Line | 24101 NEWHALL AVE
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City | ROSEDALE
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State | NY
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Zip | 11422-2408
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Country | US
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Telephone | 347-693-4311
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Fax |
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Provider Business Mailing Address
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Address Line | 32 N MONTAGUE ST
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City | VALLEY STREAM
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State | NY
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Zip | 11580-3708
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Country | US
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Telephone | 347-693-4311
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF PSYCHIATRY
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Name | DR. CHUKWUKA MORDI
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Credential | FPMHNP
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Telephone | 347-693-4311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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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 | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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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 | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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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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