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General NPI Number Information
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NPI Number | 1851211874
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Entity Type | Organization
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Legal Business Name | MIND HARBOR NURSE PRACTITIONER IN PSYCHIATRY SERVICES PLLC
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Dates
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Enumeration Date | 07/20/2026
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Last Update Date | 07/20/2026
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Provider Practice Location Address
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Address Line | 1251 E 56TH STREET
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City | BROOKLYN
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State | NY
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Zip | 11234
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Country | US
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Telephone | 484-542-3768
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Fax |
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Provider Business Mailing Address
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Address Line | 1280 LEXINGTON AVE FRNT 2
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City | NEW YORK
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State | NY
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Zip | 10028-2136
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Country | US
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Telephone | 484-542-3768
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JERMAINE NNAETO
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Credential |
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Telephone | 484-542-3768
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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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