Provider Demographics
NPI:1265855167
Name:ANGLIN, TAMIKA S (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:TAMIKA
Middle Name:S
Last Name:ANGLIN
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 N BROADWAY
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10603-2427
Mailing Address - Country:US
Mailing Address - Phone:914-423-4433
Mailing Address - Fax:914-423-9434
Practice Address - Street 1:845 N BROADWAY
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10603-2427
Practice Address - Country:US
Practice Address - Phone:914-423-4433
Practice Address - Fax:914-423-9434
Is Sole Proprietor?:No
Enumeration Date:2014-01-28
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY402769363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health