Provider Demographics
NPI:1689402307
Name:BROOKLYN PSYCHIATRIC NURSE PRACTITIONER SERVICES PC
Entity type:Organization
Organization Name:BROOKLYN PSYCHIATRIC NURSE PRACTITIONER SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:FELDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:929-367-7419
Mailing Address - Street 1:286 UNION AVE APT 1A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-5804
Mailing Address - Country:US
Mailing Address - Phone:929-367-7419
Mailing Address - Fax:
Practice Address - Street 1:109 N 12TH ST STE 827
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11249-1002
Practice Address - Country:US
Practice Address - Phone:929-367-7419
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty