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NPI Code Detail

MEDICARE: YANDAMA BANGURA

MEDICARE: YANDAMA BANGURA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse PractitionerSP016689PA
2363LP0808XPsychiatric/Mental Health Nurse PractitionerF403907NY

General Provider Information

NPI Number : 1083166045
Entity Type Code : Individual
Provider Name (Legal Business Name) : YANDAMA BANGURA
Provider Business Mailing Address
First Line : 1225 FRANKLIN AVE STE 325
Second Line :
City : GARDEN CITY
State : NY
Zip : 11530-1693
Country : US
Telephone Number : 516-271-1919
Fax Number : 516-529-6067
Provider Business Practice Location Address
First Line : 1225 FRANKLIN AVE STE 325
Second Line :
City : GARDEN CITY
State : NY
Zip : 11530-1693
Country : US
Telephone Number : 516-271-1919
Fax Number : 516-529-6067
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2016
Last Update Date : 04/16/2026

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Directions to “ YANDAMA BANGURA ” Practice Location

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