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General NPI Number Information
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NPI Number | 1982557773
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Entity Type | Organization
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Legal Business Name | HAVEN REEF NURSE PRACTITIONER IN PSYCHIATRY PLLC
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Dates
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Enumeration Date | 02/19/2026
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Last Update Date | 02/19/2026
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Provider Practice Location Address
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Address Line | 114 5TH AVE FLOOR 2
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City | NEW YORK
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State | NY
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Zip | 10011
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Country | US
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Telephone | 646-212-0063
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 120160
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City | STATEN ISLAND
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State | NY
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Zip | 10312-0160
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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 | OWNER
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Name | SOLOMON WEAVER
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Credential | PMHNP
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Telephone | 646-942-7828
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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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