| Kristen Briody, Llc | |
|
107 W Main St East Islip NY 11730-2337 | |
| (631) 666-1615 | |
| Not Available |
| Full Name | Kristen Briody, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 107 W Main St, East Islip, New York |
| Authorized Official Name and Position | Kristen Briody (PMHNP-BC) |
| Authorized Official Contact | 6316661615 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kristen Briody, Llc 107 W Main St East Islip NY 11730-2337 Ph: (631) 666-1615 | Kristen Briody, Llc 107 W Main St East Islip NY 11730-2337 Ph: (631) 666-1615 |
| NPI Number | 1346999372 |
|---|---|
| Provider Enumeration Date | 03/18/2022 |
| Last Update Date | 03/18/2022 |
| Certification Date | 03/18/2022 |
| Medicare PECOS PAC ID | 0749675270 |
|---|---|
| Medicare Enrollment ID | O20220321001733 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346999372 | NPI | - | NPPES |
| 123456789 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Kristen Rose Briody |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700345717 PECOS PAC ID: 2062747579 Enrollment ID: I20220321002230 |
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