MEDICARE: MR. CARL YOURI TELEUS PMHNP

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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	407716	NY

General Provider Information

NPI Number	:	1376406140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CARL YOURI TELEUS PMHNP

Provider Business Mailing Address
First Line	:	215 W 95TH ST APT 7G
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10025-6354
Country	:	US
Telephone Number	:	786-425-7633
Fax Number	:

Provider Business Practice Location Address
First Line	:	2351 BEDFORD AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11226-5403
Country	:	US
Telephone Number	:	844-400-1975
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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