Provider Demographics
NPI:1790655827
Name:JS NP IN PSYCHIATRY AND FAMILY HEALTH PC
Entity type:Organization
Organization Name:JS NP IN PSYCHIATRY AND FAMILY HEALTH PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SEIDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-887-5994
Mailing Address - Street 1:42 BROADWAY FL 12
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10004-1617
Mailing Address - Country:US
Mailing Address - Phone:646-887-5994
Mailing Address - Fax:
Practice Address - Street 1:42 BROADWAY FL 12
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10004-1617
Practice Address - Country:US
Practice Address - Phone:646-887-5994
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-05
Last Update Date:2025-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty