Provider Demographics
NPI:1477166585
Name:NURSE PRACTITIONER PSYCHIATRY & PSYCHOLOGY SERVICES, PLLC
Entity Type:Organization
Organization Name:NURSE PRACTITIONER PSYCHIATRY & PSYCHOLOGY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMBOM
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:516-466-2636
Mailing Address - Street 1:310 E SHORE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11023-2432
Mailing Address - Country:US
Mailing Address - Phone:516-466-2636
Mailing Address - Fax:516-464-0203
Practice Address - Street 1:310 E SHORE RD STE 100
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11023-2432
Practice Address - Country:US
Practice Address - Phone:516-466-2636
Practice Address - Fax:516-464-0203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth ServiceGroup - Single Specialty