Organization
CANAAN PSYCHIATRIC AND ADDICTION SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN OBI PSYCHIATRIC NP (AUTHORIZED OFFICIAL)
(973) 342-5593
Entity
Organization
Contact information
Practice address
4377 BRONX BLVD, BRONX, NY 10466-1397
(347) 912-7566
(646) 490-8780
Mailing address
1131 ELKER RD, UNION, NJ 07083-5006
(347) 912-7566
(646) 490-8780
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5427909
—
NY
Enumeration date
10/19/2021
Last updated
10/19/2021
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