Provider Demographics
NPI:1831424217
Name:IGHAROSA, MAUREEN (DNP, MSN, PMHNP-BC)
Entity type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:
Last Name:IGHAROSA
Suffix:
Gender:F
Credentials:DNP, MSN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 COURTLANDT AVE FL 5
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-5032
Mailing Address - Country:US
Mailing Address - Phone:212-939-1787
Mailing Address - Fax:
Practice Address - Street 1:510 COURTLANDT AVE FL 5
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5032
Practice Address - Country:US
Practice Address - Phone:646-262-8212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-02
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY589920163W00000X
NY404691363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse