| Life Reimagined, Np In Psychiatry, Pllc | |
|
51 Commander Ave Garden City NY 11530-6607 | |
| (516) 642-5761 | |
| Not Available |
| Full Name | Life Reimagined, Np In Psychiatry, Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 51 Commander Ave, Garden City, New York |
| Authorized Official Name and Position | Tashonna Webster (OWNER) |
| Authorized Official Contact | 5162291394 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Reimagined, Np In Psychiatry, Pllc 405 Rxr Plz Uniondale NY 11556-3811 Ph: () - | Life Reimagined, Np In Psychiatry, Pllc 51 Commander Ave Garden City NY 11530-6607 Ph: (516) 642-5761 |
| NPI Number | 1154038263 |
|---|---|
| Provider Enumeration Date | 10/31/2022 |
| Last Update Date | 10/31/2022 |
| Certification Date | 10/30/2022 |
| Medicare PECOS PAC ID | 0840669321 |
|---|---|
| Medicare Enrollment ID | O20221205001857 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154038263 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Tashonna Rasheen Webster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336811074 PECOS PAC ID: 7113311994 Enrollment ID: I20220221000590 |
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