Provider Demographics
NPI:1073382412
Name:AP NP IN PSYCHIATRY PC
Entity Type:Organization
Organization Name:AP NP IN PSYCHIATRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:PLISCHTEJEW
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:631-401-5834
Mailing Address - Street 1:77 N CENTRE AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CTR
Mailing Address - State:NY
Mailing Address - Zip Code:11570-3923
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:77 N CENTRE AVE STE 207
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CTR
Practice Address - State:NY
Practice Address - Zip Code:11570-3923
Practice Address - Country:US
Practice Address - Phone:631-401-5834
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-27
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty