| Premier Psychiatric Consultants Llc | |
|
6000 Washington St West New York NJ 07093-1420 | |
| (201) 864-4897 | |
| (201) 864-4871 |
| Full Name | Premier Psychiatric Consultants Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6000 Washington St, West New York, New Jersey |
| Authorized Official Name and Position | Yissell Delvalle (PRESIDENT) |
| Authorized Official Contact | 9173454273 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Psychiatric Consultants Llc 6000 Washington St West New York NJ 07093-1420 Ph: (201) 864-4897 | Premier Psychiatric Consultants Llc 6000 Washington St West New York NJ 07093-1420 Ph: (201) 864-4897 |
| NPI Number | 1508182072 |
|---|---|
| Provider Enumeration Date | 04/08/2010 |
| Last Update Date | 12/07/2022 |
| Certification Date | 12/07/2022 |
| Medicare PECOS PAC ID | 7315077120 |
|---|---|
| Medicare Enrollment ID | O20100604000555 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508182072 | NPI | - | NPPES |
| 1750585709 | Other | NJ | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 25MA0821070 (New Jersey) | Primary |
| Provider Name | Yissell Delvalle |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750585709 PECOS PAC ID: 8325131402 Enrollment ID: I20070905000682 |
| Provider Name | Ariel G Almacen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033257241 PECOS PAC ID: 8224193123 Enrollment ID: I20090210000050 |
| Provider Name | Omayra Ortiz |
|---|---|
| Provider Type | Practitioner - Geriatric Psychiatry |
| Provider Identifiers | NPI Number: 1124068853 PECOS PAC ID: 3476573510 Enrollment ID: I20131011001556 |
| Provider Name | Andrea S Wagner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710498068 PECOS PAC ID: 1052672375 Enrollment ID: I20180301002116 |
| Provider Name | Maria E Laqui |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598072100 PECOS PAC ID: 0648504738 Enrollment ID: I20210907002001 |
| Provider Name | Cassandra David |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629536610 PECOS PAC ID: 2365831195 Enrollment ID: I20230123001394 |
| Provider Name | Kristina Way |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952020406 PECOS PAC ID: 0749645042 Enrollment ID: I20230420000115 |
| Provider Name | John Edward Wagner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649813973 PECOS PAC ID: 7012364698 Enrollment ID: I20231104000127 |
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