Provider Demographics
NPI:1427416866
Name:MENSAH, RENEE A (PMHNP-BC)
Entity Type:Individual
Prefix:MS
First Name:RENEE
Middle Name:A
Last Name:MENSAH
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 1:127 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-4006
Mailing Address - Country:US
Mailing Address - Phone:401-338-6487
Mailing Address - Fax:
Practice Address - Street 1:127 S BROADWAY
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-4006
Practice Address - Country:US
Practice Address - Phone:401-338-6487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-31
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY715395163WP0808X
RIRN49396163WP0808X
NYF402080363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00695941Medicaid
WI331945Medicare Oscar/Certification
WI331944Medicare Oscar/Certification
WI331946Medicare Oscar/Certification
WI331947Medicare Oscar/Certification
WIW6L111Medicare Oscar/Certification
WI331943Medicare Oscar/Certification
WIG100000410Medicare Oscar/Certification
NY00695941Medicaid
WI331043Medicare Oscar/Certification
WI331952Medicare Oscar/Certification
WI331058Medicare Oscar/Certification
WI331954Medicare Oscar/Certification
WI331978Medicare Oscar/Certification