Provider Demographics
NPI:1780284273
Name:PLISCHTEJEW, ANGELA A (PFMHNP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:A
Last Name:PLISCHTEJEW
Suffix:
Gender:F
Credentials:PFMHNP
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:ABRAMOV
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PMHNP-BC
Mailing Address - Street 1:604 OCEANPOINT AVE
Mailing Address - Street 2:
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-1301
Mailing Address - Country:US
Mailing Address - Phone:347-653-3067
Mailing Address - Fax:
Practice Address - Street 1:604 OCEANPOINT AVE
Practice Address - Street 2:
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-1301
Practice Address - Country:US
Practice Address - Phone:347-653-3067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-26
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF403240-01363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health