| Queens Nassau Mental Health Counseling Pllc | |
|
40 South 16th Street New Hyde Park NY 11040-4915 | |
| (917) 933-0584 | |
| (718) 806-1435 |
| Full Name | Queens Nassau Mental Health Counseling Pllc |
|---|---|
| Speciality | Exclusive Provider Organization |
| Location | 40 South 16th Street, New Hyde Park, New York |
| Authorized Official Name and Position | Eshika Kalam (PRESIDENT) |
| Authorized Official Contact | 9179330584 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Queens Nassau Mental Health Counseling Pllc 40 South 16th Street New Hyde Park NY 11040-4915 Ph: (917) 933-0584 | Queens Nassau Mental Health Counseling Pllc 40 South 16th Street New Hyde Park NY 11040-4915 Ph: (917) 933-0584 |
| NPI Number | 1093336125 |
|---|---|
| Provider Enumeration Date | 04/29/2020 |
| Last Update Date | 04/29/2020 |
| Certification Date | 04/29/2020 |
| Medicare PECOS PAC ID | 6204379076 |
|---|---|
| Medicare Enrollment ID | O20240620004018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093336125 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 302F00000X | Exclusive Provider Organization | (* (Not Available)) | Primary |
| Provider Name | Eshika Kalam |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669879250 PECOS PAC ID: 5496198640 Enrollment ID: I20240205003811 |
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