# ARCK NURSE PRACTITIONER IN PSYCHIATRY PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700464682
- **Authorized official:** DR. RICARDO MILLER (NURSE PRACTITIONER)
- **Authorized official phone:** (516) 568-7032

## Contact information

- **Practice address:** 111 SMITHTOWN BYP STE 122, HAUPPAUGE, NY 11788-2512
- **Practice address phone:** (516) 568-7032
- **Mailing address:** 115 S CORONA AVE, VALLEY STREAM, NY 11580-6217

## Taxonomy

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

## Other

- **Enumeration date:** 03/31/2021
- **Last updated:** 03/31/2021