Provider Demographics
NPI:1982481941
Name:QUALITY TELEHEALTH NP IN PSYCHIATRY, PLLC
Entity type:Organization
Organization Name:QUALITY TELEHEALTH NP IN PSYCHIATRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER IN PSYCHIATRY
Authorized Official - Prefix:
Authorized Official - First Name:YANDAMA
Authorized Official - Middle Name:
Authorized Official - Last Name:BANGURA
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:838-200-6310
Mailing Address - Street 1:242 BAYARD RD
Mailing Address - Street 2:
Mailing Address - City:UPPER DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19082-4704
Mailing Address - Country:US
Mailing Address - Phone:610-304-9554
Mailing Address - Fax:
Practice Address - Street 1:401 NEW KARNER RD STE 301
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-3854
Practice Address - Country:US
Practice Address - Phone:838-200-6310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-13
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health