Provider Demographics
NPI:1114731866
Name:STUDIO HEALTH NP IN PSYCHIATRY AND NP IN FAMILY HEALTH PC
Entity type:Organization
Organization Name:STUDIO HEALTH NP IN PSYCHIATRY AND NP IN FAMILY HEALTH PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:EBONY
Authorized Official - Last Name:GIBSON-SIMMS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:347-512-1057
Mailing Address - Street 1:1760 UTICA AVE # 1160
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-2121
Mailing Address - Country:US
Mailing Address - Phone:347-512-1057
Mailing Address - Fax:
Practice Address - Street 1:4595 KINGS HWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-1433
Practice Address - Country:US
Practice Address - Phone:347-991-0090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health