Provider Demographics
NPI:1609627595
Name:DVH NP IN PSYCHIATRY SERVICES PLLC
Entity Type:Organization
Organization Name:DVH NP IN PSYCHIATRY SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:BRADFORD
Authorized Official - Last Name:VON HOLTEN
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:347-573-9479
Mailing Address - Street 1:2093 PHILADELPHIA PIKE # 7683
Mailing Address - Street 2:
Mailing Address - City:CLAYMONT
Mailing Address - State:DE
Mailing Address - Zip Code:19703-2424
Mailing Address - Country:US
Mailing Address - Phone:347-573-9479
Mailing Address - Fax:
Practice Address - Street 1:1185 AVENUE OF THE AMERICAS FL 3
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-2600
Practice Address - Country:US
Practice Address - Phone:347-573-9479
Practice Address - Fax:347-745-5913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty