Provider Demographics
NPI:1124647003
Name:SP, NP IN PSYCHIATRY PLLC
Entity type:Organization
Organization Name:SP, NP IN PSYCHIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:SOHAMY
Authorized Official - Middle Name:
Authorized Official - Last Name:PINARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-600-9704
Mailing Address - Street 1:1718 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-1109
Mailing Address - Country:US
Mailing Address - Phone:646-600-9704
Mailing Address - Fax:
Practice Address - Street 1:159 20TH ST STE 1B
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11232-1254
Practice Address - Country:US
Practice Address - Phone:646-600-9704
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-10
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty