MEDICARE: ANDREA VOGEL 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	402017	NY

General Provider Information

NPI Number	:	1669925848
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA VOGEL PMHNP

Provider Business Mailing Address
First Line	:	92 PROSPECT PL
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11217-2804
Country	:	US
Telephone Number	:	307-264-0207
Fax Number	:	979-270-9159

Provider Business Practice Location Address
First Line	:	92 PROSPECT PL
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11217-2804
Country	:	US
Telephone Number	:	307-264-0207
Fax Number	:	979-270-9159

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

Provider Enumeration Date	:	07/25/2016
Last Update Date	:	10/21/2020

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