Provider Demographics
NPI:1467210567
Name:MINDSPACE HEALTH NP IN PSYCHIATRY PLLC
Entity Type:Organization
Organization Name:MINDSPACE HEALTH NP IN PSYCHIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONNA-KAY
Authorized Official - Middle Name:
Authorized Official - Last Name:HYLTON
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, PMHNP
Authorized Official - Phone:646-245-8933
Mailing Address - Street 1:1 BUCKINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954-1312
Mailing Address - Country:US
Mailing Address - Phone:646-245-8933
Mailing Address - Fax:
Practice Address - Street 1:1 BUCKINGHAM RD
Practice Address - Street 2:
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954-1312
Practice Address - Country:US
Practice Address - Phone:646-245-8933
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty