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Organization
ALBATROSS TO PHOENIX PSYCHIATRY LLC
Active
Organization
ALBATROSS TO PHOENIX PSYCHIATRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICKY JAMES JEWELL APN (ADVANCED PRACTICE NURSE)
(862) 774-4562
Entity
Organization
Contact information
Practice address
111 TOWN SQUARE PL STE 1238, JERSEY CITY, NJ 07310-1810
(201) 757-2531
Mailing address
111 TOWN SQUARE PL, SUITE 1238 PMB 801874, JERSEY CITY, NJ 07310
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
02/19/2024
Last updated
02/19/2024
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