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NPI Code Detail

MEDICARE: INTEGRATIVE WELLNESS NURSE PRACTITIONER IN PSYCHIATRY LLC

MEDICARE: INTEGRATIVE WELLNESS NURSE PRACTITIONER IN PSYCHIATRY LLC
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 : 1841014057
Entity Type Code : Organization
Provider Name (Legal Business Name) : INTEGRATIVE WELLNESS NURSE PRACTITIONER IN PSYCHIATRY LLC
Provider Business Mailing Address
First Line : 157 E 86TH ST FL 4
Second Line :
City : NEW YORK
State : NY
Zip : 10028-2175
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 300 CARNEGIE CTR STE 150
Second Line :
City : PRINCETON
State : NJ
Zip : 08540-6285
Country : US
Telephone Number : 718-790-4511
Fax Number :
Authorized Official
Title or Position : EXECUTIVE ASSOCIATE
Name : CLAUDIA MCBRIDE
Credential :
Telephone Number : 225-235-4984
Provider Enumeration Date : 11/13/2024
Last Update Date : 11/14/2024

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Directions to “INTEGRATIVE WELLNESS NURSE PRACTITIONER IN PSYCHIATRY LLC ” Practice Location

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