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NPI Code Detail

MEDICARE: AILEEN IDA ACKERMAN PMHNP-BC

MEDICARE: AILEEN IDA ACKERMAN PMHNP-BC
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 Practitioner16154CT

General Provider Information

NPI Number : 1457217408
Entity Type Code : Individual
Provider Name (Legal Business Name) : AILEEN IDA ACKERMAN PMHNP-BC
Provider Business Mailing Address
First Line : 187 LOVERS LN
Second Line :
City : TORRINGTON
State : CT
Zip : 06790-4356
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 27 RANDOLPH RD
Second Line :
City : HOWELL
State : NJ
Zip : 07731-8611
Country : US
Telephone Number : 866-708-1240
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/02/2026
Last Update Date : 01/10/2026

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