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Organization
CANAAN PSYCHIATRIC AND ADDICTION SERVICES LLC
Active
Organization
CANAAN PSYCHIATRIC AND ADDICTION SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN OBI PSYCHIATRIC NP (AUTHORIZED OFFICIAL)
(973) 342-5593
Entity
Organization
Contact information
Practice address
4377 BRONX BLVD, BRONX, NY 10466-1397
(347) 912-7566
(646) 490-8780
Mailing address
1131 ELKER RD, UNION, NJ 07083-5006
(347) 912-7566
(646) 490-8780
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5427909
—
NY
Enumeration date
10/19/2021
Last updated
10/19/2021
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