Provider Demographics
NPI:1982381877
Name:CORNERSTONE NP IN PSYCHIATRY, PLLC
Entity type:Organization
Organization Name:CORNERSTONE NP IN PSYCHIATRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:TOLULOPE
Authorized Official - Middle Name:OLAJUMOKE
Authorized Official - Last Name:KOLAWOLE
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, MHNP-BC, MSN
Authorized Official - Phone:718-200-5446
Mailing Address - Street 1:7315 LONGSPUR HOLLOW LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-4704
Mailing Address - Country:US
Mailing Address - Phone:973-687-4145
Mailing Address - Fax:
Practice Address - Street 1:1441 BROADWAY STE 6026
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-1851
Practice Address - Country:US
Practice Address - Phone:718-200-5446
Practice Address - Fax:713-730-3639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-03
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0656623Medicaid