Provider Demographics
NPI:1982213005
Name:EMPIRE NP PSYCHIATRY PC
Entity Type:Organization
Organization Name:EMPIRE NP PSYCHIATRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WARTENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:516-784-0377
Mailing Address - Street 1:2 HAZEL PL
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1108
Mailing Address - Country:US
Mailing Address - Phone:516-784-0377
Mailing Address - Fax:
Practice Address - Street 1:100 N VILLAGE AVE STE 27
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-3712
Practice Address - Country:US
Practice Address - Phone:516-784-0377
Practice Address - Fax:516-888-8235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-24
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY05911624Medicaid
NY1062908OtherBEACON HEALTH OPTIONS