Affect Therapeutics, Inc. | |
1202 Central Ave Sw Ste 19 Albuquerque NM 87102-2803 | |
(845) 769-8758 | |
Not Available |
Full Name | Affect Therapeutics, Inc. |
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Speciality | Clinic/Center |
Location | 1202 Central Ave Sw Ste 19, Albuquerque, New Mexico |
Authorized Official Name and Position | Karla Renee Mullings (DIRECTOR CLINICAL COMPLIANCE) |
Authorized Official Contact | 3235222218 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Affect Therapeutics, Inc. 520 Broadway Fl 4 New York NY 10012-4436 Ph: () - | Affect Therapeutics, Inc. 1202 Central Ave Sw Ste 19 Albuquerque NM 87102-2803 Ph: (845) 769-8758 |
NPI Number | 1942948351 |
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Provider Enumeration Date | 05/25/2022 |
Last Update Date | 05/25/2022 |
Certification Date | 05/25/2022 |
Medicare PECOS PAC ID | 4284071903 |
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Medicare Enrollment ID | O20240502000830 |
Identifier | Type | State | Issuer |
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1942948351 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
Provider Name | Nonye Frances Nwokoro |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1811544000 PECOS PAC ID: 0749618734 Enrollment ID: I20211110001199 |
Provider Name | Kenyua Johnson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1669815478 PECOS PAC ID: 0941438998 Enrollment ID: I20230908002906 |
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