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Organization
LOTUS NP IN PSYCHIATRY PLLC
Active
Organization
LOTUS NP IN PSYCHIATRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JATOOPON MALDONADO PMHNP (NURSE PRACTITIONER)
(718) 764-3164
Entity
Organization
Contact information
Practice address
555 BROADHOLLOW RD STE 305, MELVILLE, NY 11747-5018
(646) 995-2360
Mailing address
PO BOX 509, DEER PARK, NY 11729-0509
(718) 764-3164
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/13/2023
Last updated
07/13/2023
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