# EC PSYCHIATRIC NURSE PRACTITIONER PLLC

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

## Provider details

- **NPI number:** 1790483766
- **Authorized official:** EDNER CUVILLY NPP (NURSE PRACTITIONER PSYCHIATRY)
- **Authorized official phone:** (646) 671-1187

## Contact information

- **Practice address:** 21 ROBIN HOOD RD, SUFFERN, NY 10901-3820
- **Practice address phone:** (646) 671-1187
- **Mailing address:** 115 FRANKLIN TURNPIKE, PO BOX 168, MAHWAH, NJ 07430
- **Mailing address phone:** (646) 671-1187

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 02/20/2023
- **Last updated:** 02/20/2023