| Bridge To Care Nurse Practitioner In Psychiatry Pc | |
|
3005 Church Ave Brooklyn NY 11226-4209 | |
| (347) 627-6100 | |
| Not Available |
| Full Name | Bridge To Care Nurse Practitioner In Psychiatry Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3005 Church Ave, Brooklyn, New York |
| Authorized Official Name and Position | Henrietta O Okpala (PMHNP) |
| Authorized Official Contact | 7182880979 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bridge To Care Nurse Practitioner In Psychiatry Pc 10536 Avenue K Brooklyn NY 11236-3018 Ph: (347) 627-6100 | Bridge To Care Nurse Practitioner In Psychiatry Pc 3005 Church Ave Brooklyn NY 11226-4209 Ph: (347) 627-6100 |
| NPI Number | 1649884537 |
|---|---|
| Provider Enumeration Date | 09/08/2020 |
| Last Update Date | 09/08/2020 |
| Medicare PECOS PAC ID | 7618397241 |
|---|---|
| Medicare Enrollment ID | O20201020000720 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649884537 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Alexander I Gumbs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750764007 PECOS PAC ID: 4385923549 Enrollment ID: I20161111000910 |
| Provider Name | Henrietta Oby Okpala |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164414512 PECOS PAC ID: 9436389665 Enrollment ID: I20200212001630 |
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