Provider Demographics
NPI:1982481941
Name:QUALITY TELEHEALTH NP IN PSYCHIATRY, PLLC
Entity Type:Organization
Organization Name:QUALITY TELEHEALTH NP IN PSYCHIATRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER IN PSYCHIATRY
Authorized Official - Prefix:
Authorized Official - First Name:YANDAMA
Authorized Official - Middle Name:
Authorized Official - Last Name:BANGURA
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:838-200-6310
Mailing Address - Street 1:1060 BROADWAY
Mailing Address - Street 2:#1088
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12204
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:418 BROADWAY STE N
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12207-2922
Practice Address - Country:US
Practice Address - Phone:838-200-6310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health