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NPI Code Detail

MEDICARE: QUALITY TELEHEALTH NP IN PSYCHIATRY, PLLC

MEDICARE: QUALITY TELEHEALTH NP IN PSYCHIATRY, PLLC
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
1261QM0850XAdult Mental Health Clinic/Center

General Provider Information

NPI Number : 1982481941
Entity Type Code : Organization
Provider Name (Legal Business Name) : QUALITY TELEHEALTH NP IN PSYCHIATRY, PLLC
Provider Business Mailing Address
First Line : 1225 FRANKLIN AVE STE 325
Second Line :
City : GARDEN CITY
State : NY
Zip : 11530-1693
Country : US
Telephone Number : 516-271-1919
Fax Number : 516-529-6067
Provider Business Practice Location Address
First Line : 1225 FRANKLIN AVE STE 325
Second Line :
City : GARDEN CITY
State : NY
Zip : 11530-1693
Country : US
Telephone Number : 516-271-1919
Fax Number : 516-529-6067
Authorized Official
Title or Position : PMHNP-BC
Name : YANDAMA BANGURA
Credential :
Telephone Number : 516-271-1919
Provider Enumeration Date : 09/13/2023
Last Update Date : 04/16/2026

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1396261400 — NICOLE CESTRO MS, CCC-SLP
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1265959167 — MRS. DIANA GERARDI CCC-SLP
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