Provider Demographics
NPI:1265711386
Name:PRESHLOCK, KIMBERLY MARIE (PMHNP-C)
Entity type:Individual
Prefix:MISS
First Name:KIMBERLY
Middle Name:MARIE
Last Name:PRESHLOCK
Suffix:
Gender:F
Credentials:PMHNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 MERRITTS RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-3216
Mailing Address - Country:US
Mailing Address - Phone:516-668-6853
Mailing Address - Fax:
Practice Address - Street 1:150 MERRITTS RD
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-3216
Practice Address - Country:US
Practice Address - Phone:516-668-6853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-07
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY406708363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health