Provider Demographics
NPI:1437734639
Name:DYNAMIC MENTAL HEALTH OF NEW ENGLAND, PLLC
Entity Type:Organization
Organization Name:DYNAMIC MENTAL HEALTH OF NEW ENGLAND, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:POOJA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEEMA
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, PMHNP-BC
Authorized Official - Phone:603-716-1924
Mailing Address - Street 1:80 PALOMINO LN STE 203
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6447
Mailing Address - Country:US
Mailing Address - Phone:603-716-1924
Mailing Address - Fax:949-561-5020
Practice Address - Street 1:80 PALOMINO LN STE 203
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6447
Practice Address - Country:US
Practice Address - Phone:603-716-1924
Practice Address - Fax:949-561-5020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-10
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty