| Private Practice Center Of Ny | |
|
3016 31st St Astoria NY 11102-1866 | |
| (917) 557-5741 | |
| (347) 935-3936 |
| Full Name | Private Practice Center Of Ny |
|---|---|
| Speciality | Nurse Practitioner - Psychiatric/mental Health |
| Location | 3016 31st St, Astoria, New York |
| Authorized Official Name and Position | Sharon De Jesus (NURSE PRACTITIONER/OWNER) |
| Authorized Official Contact | 3479353333 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Private Practice Center Of Ny 3016 31st St Main Fl Astoria NY 11102-1866 Ph: (347) 935-3333 | Private Practice Center Of Ny 3016 31st St Astoria NY 11102-1866 Ph: (917) 557-5741 |
| NPI Number | 1538398052 |
|---|---|
| Provider Enumeration Date | 07/06/2009 |
| Last Update Date | 01/22/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538398052 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 400845 (New York) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 400845 (New York) | Primary |
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