Facts
- Status
- A
- Credential
- CNS NP in Psychiatry
- Type
- Individual
- Enumeration date
- 2007-08-09
- Last updated
- 2007-08-09
Licenses
- License NY
- 2195251
- License NY
- F400512
- License NY
- 0108674
Location
- Practice location
- 71 21 244 ST, WINCHESTER CONSULTATION
- City
- DOUGLASTON NY
- Postal code
- 113621913
- Phone
- 718-224-9193
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
The OIG NPI list is not in this build yet. Confirm on OIG's search.
Nearby
Search this city from the state hub for other records in the public registry.
Removal request
Public data from NPPES and CMS. Not a credentialing determination.