Provider Demographics
NPI:1790487619
Name:R. PREVILLON NP IN PSYCHIATRY P.C.
Entity Type:Organization
Organization Name:R. PREVILLON NP IN PSYCHIATRY P.C.
Other - Org Name:NEWMIND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RASHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:PREVILLON
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:347-947-2665
Mailing Address - Street 1:3010 41ST AVE STE 238
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-2814
Mailing Address - Country:US
Mailing Address - Phone:347-947-2665
Mailing Address - Fax:347-732-2087
Practice Address - Street 1:3010 41ST AVE STE 238
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-2814
Practice Address - Country:US
Practice Address - Phone:347-947-2665
Practice Address - Fax:347-732-2087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-22
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty