# EMERGING PATH NURSE PRACTITIONER IN PSYCHIATRY, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** EMERGING PATH NURSE PRACTITIONER IN
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528946829
- **Authorized official:** TINA DANTONIO (OFFICE MANAGER)
- **Authorized official phone:** (631) 629-2879

## Contact information

- **Practice address:** 315 WALT WHITMAN RD STE 210, HUNTINGTON STATION, NY 11746-4112
- **Practice address phone:** (631) 629-2879
- **Practice address fax:** (949) 864-3515
- **Mailing address:** 315 WALT WHITMAN RD STE 210, HUNTINGTON STATION, NY 11746-4112
- **Mailing address phone:** (631) 629-2879
- **Mailing address fax:** (949) 864-3515

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 08/25/2025
- **Last updated:** 08/27/2025