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General NPI Number Information
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NPI Number | 1952962227
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Entity Type | Individual
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Provider Name | RICHARD CALLADO PMHNP
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Gender | Male
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Dates
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Enumeration Date | 06/26/2019
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Last Update Date | 11/21/2019
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Provider Practice Location Address
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Address Line | 245 5TH AVE STE 336
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City | NEW YORK
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State | NY
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Zip | 10016
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Country | US
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Telephone | 718-720-3074
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Fax |
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Provider Business Mailing Address
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Address Line | 10 HALLETTS PT
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City | ASTORIA
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State | NY
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Zip | 11102-1677
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Country | US
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Telephone | 718-720-3074
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 402693
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License Number State | NY
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