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NPI Code Detail

MEDICARE: SP NP IN PSYCHIATRY

MEDICARE: SP NP IN PSYCHIATRY
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 Practitioner

General Provider Information

NPI Number : 1124647003
Entity Type Code : Organization
Provider Name (Legal Business Name) : SP NP IN PSYCHIATRY
Provider Business Mailing Address
First Line : 1718 11TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11218-1109
Country : US
Telephone Number : 646-600-9704
Fax Number :
Provider Business Practice Location Address
First Line : 159 20TH ST STE 1B
Second Line :
City : BROOKLYN
State : NY
Zip : 11232-1254
Country : US
Telephone Number : 646-600-9704
Fax Number :
Authorized Official
Title or Position : PSYCHIATRIC NURSE PRACTITIONER
Name : SOHAMY PINARD
Credential :
Telephone Number : 646-600-9704
Provider Enumeration Date : 04/10/2020
Last Update Date : 02/26/2026

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