Provider Demographics
NPI:1558008938
Name:PSYCHIATRIC NP CONSULTANTS OF NORTHEASTERN NY PLLC
Entity Type:Organization
Organization Name:PSYCHIATRIC NP CONSULTANTS OF NORTHEASTERN NY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MOREY
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:518-932-9900
Mailing Address - Street 1:4 PINE WEST PLZ STE 402
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-5515
Mailing Address - Country:US
Mailing Address - Phone:518-782-3703
Mailing Address - Fax:518-608-6103
Practice Address - Street 1:4 PINE WEST PLZ STE 402
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-5515
Practice Address - Country:US
Practice Address - Phone:518-782-3703
Practice Address - Fax:518-608-6103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-17
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)