Provider Demographics
NPI:1912649625
Name:SOOKDEO, ANANT NICHOLAS (RN PMH-BC)
Entity Type:Individual
Prefix:MR
First Name:ANANT
Middle Name:NICHOLAS
Last Name:SOOKDEO
Suffix:
Gender:M
Credentials:RN PMH-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2797 FORD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-1725
Mailing Address - Country:US
Mailing Address - Phone:929-239-6134
Mailing Address - Fax:
Practice Address - Street 1:2797 FORD ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-1725
Practice Address - Country:US
Practice Address - Phone:929-239-6134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-12
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY670462163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult