| Orange County Np In Psychiatry Pllc | |
|
45 St John St Goshen NY 10924-1518 | |
| (347) 898-0813 | |
| Not Available |
| Full Name | Orange County Np In Psychiatry Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 45 St John St, Goshen, New York |
| Authorized Official Name and Position | Jacqueline Dongmo Mekontchou (PROVIDER/OWNER) |
| Authorized Official Contact | 3478980813 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Orange County Np In Psychiatry Pllc 45 St John St Goshen NY 10924-1518 Ph: () - | Orange County Np In Psychiatry Pllc 45 St John St Goshen NY 10924-1518 Ph: (347) 898-0813 |
| NPI Number | 1043099799 |
|---|---|
| Provider Enumeration Date | 09/22/2023 |
| Last Update Date | 09/22/2023 |
| Certification Date | 09/22/2023 |
| Medicare PECOS PAC ID | 1153778600 |
|---|---|
| Medicare Enrollment ID | O20231106002604 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043099799 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Fabius Mekontchou |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508106287 PECOS PAC ID: 6709286727 Enrollment ID: I20210614001671 |
| Provider Name | Jacqueline Celine L Dongmo Mekontchou |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225453715 PECOS PAC ID: 1759797665 Enrollment ID: I20230609000811 |
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