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General NPI Number Information
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NPI Number | 1750205985
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Entity Type | Organization
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Legal Business Name | CC NP IN PSYCHIATRY PLLC
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Dates
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Enumeration Date | 08/10/2026
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Last Update Date | 08/10/2026
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Provider Practice Location Address
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Address Line | 177 MAIN ST STE 202
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City | HUNTINGTON
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State | NY
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Zip | 11743-6917
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Country | US
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Telephone | 516-203-8386
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Fax |
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Provider Business Mailing Address
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Address Line | 64 WOODCHUCK HOLLOW RD
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City | COLD SPRING HARBOR
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State | NY
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Zip | 11724-2435
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PSYCHIATRIC NURSE PRACTITIONER
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Name | CATHERINE COSTA GARDYN
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Credential | PMHNP-BC
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Telephone | 516-203-8386
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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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