| Ap Np In Psychiatry Pc | |
|
77 N Centre Ave Ste 207 Rockville Ctr NY 11570-3923 | |
| (631) 401-5834 | |
| Not Available |
| Full Name | Ap Np In Psychiatry Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 77 N Centre Ave Ste 207, Rockville Ctr, New York |
| Authorized Official Name and Position | Angela Plischtejew (CEO) |
| Authorized Official Contact | 6314015834 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ap Np In Psychiatry Pc 77 N Centre Ave Ste 207 Rockville Ctr NY 11570-3923 Ph: () - | Ap Np In Psychiatry Pc 77 N Centre Ave Ste 207 Rockville Ctr NY 11570-3923 Ph: (631) 401-5834 |
| NPI Number | 1073382412 |
|---|---|
| Provider Enumeration Date | 12/27/2023 |
| Last Update Date | 12/27/2023 |
| Medicare PECOS PAC ID | 9638521503 |
|---|---|
| Medicare Enrollment ID | O20240116002971 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073382412 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Secondary |
| Provider Name | Angela A Plischtejew |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780284273 PECOS PAC ID: 1052727195 Enrollment ID: I20210315002330 |