Provider Demographics
NPI:1063721157
Name:NP:MOBILE NY FAMILY & PSYCHIATRIC HOUSE CALL SERVICE
Entity type:Organization
Organization Name:NP:MOBILE NY FAMILY & PSYCHIATRIC HOUSE CALL SERVICE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:DINGWELL
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:516-495-0174
Mailing Address - Street 1:30 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-2027
Mailing Address - Country:US
Mailing Address - Phone:516-495-0174
Mailing Address - Fax:888-251-8186
Practice Address - Street 1:30 WALNUT ST
Practice Address - Street 2:
Practice Address - City:WEST HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11552-2027
Practice Address - Country:US
Practice Address - Phone:516-495-0174
Practice Address - Fax:888-251-8186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-06
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY400828-1363LP0808X
NYF333307363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty