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Organization
VICTORY NP IN PSYCHIATRY, PC
Active
Organization
VICTORY NP IN PSYCHIATRY, PC
Active
Parent organization
N/A
Other names
N/A
Organization subpart
Yes
Provider details
NPI number
Legal business name
N/A
Authorized official
MR. GODWIN MCMUKORO OKPOMO SR. NURSE PRACTITIONER (CLINICAL DIRECTOR)
(646) 384-0252
Entity
Organization
Contact information
Practice address
2962 WICKHAM AVE, BRONX, NY 10469-3324
(646) 384-0252
Mailing address
2962 WICKHAM AVE, BRONX, NY 10469-3324
(646) 384-0252
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
401152
NY
Other
Enumeration date
04/02/2016
Last updated
04/02/2016
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