# PAVEL ODINTSOV NP IN ADULT HEALTH PLLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PAVEL ODINTSOV NP IN ADULT HEALTH AND PSYCHIATRY
- **Other names:** PAVEL ODINTSOV NP IN ADULT HEALTH PLLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1851121610
- **Legal business name:** PAVEL ODINTSOV NP IN ADULT HEALTH AND PSYCHIATRY
- **Authorized official:** PAVEL ODINTSOV ADULT-NP., PMHNP. (OWNER/NURSE PRACTITIONER)
- **Authorized official phone:** (201) 665-4150

## Contact information

- **Practice address:** 182 S MAIN ST STE 106, NEW CITY, NY 10956-3318
- **Practice address phone:** (845) 358-4000
- **Mailing address:** 297 HILLSDALE AVE, HILLSDALE, NJ 07642-2212
- **Mailing address phone:** (201) 665-4150

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | Yes |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 08/06/2024
- **Last updated:** 08/06/2024