# KO NP IN PSYCHIATRY PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** KO NP in Psychiatry PC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720711435
- **Authorized official:** MRS. KIRA OPPENHEIM (PRESIDENT)
- **Authorized official phone:** (917) 553-4040

## Contact information

- **Practice address:** 1975 LINDEN BLVD, ELMONT, NY 11003-4025
- **Practice address phone:** (917) 553-4040
- **Practice address fax:** (602) 581-7755
- **Mailing address:** 262 ARDSLEY ST, STATEN ISLAND, NY 10306-1632
- **Mailing address phone:** (917) 553-4040

## 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:** 07/08/2022
- **Last updated:** 07/08/2022