Provider Demographics
NPI:1437980307
Name:MT SINAI PSYCHIATRIC SERVICES
Entity type:Organization
Organization Name:MT SINAI PSYCHIATRIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WINNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOMANYI
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:201-668-7528
Mailing Address - Street 1:103 RAVENCLIFF RDG
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-9261
Mailing Address - Country:US
Mailing Address - Phone:201-668-7528
Mailing Address - Fax:201-668-7528
Practice Address - Street 1:500 BENSON RD STE 238
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-3947
Practice Address - Country:US
Practice Address - Phone:201-668-7528
Practice Address - Fax:201-668-7528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty