Individual
MRS. VISHANTI JAIMANGAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2692 GRAND AVE, BALDWIN, NY 11510-3913
(516) 849-9313
Mailing address
2692 GRAND AVE, BALDWIN, NY 11510-3913
(516) 849-9313
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
407115
NY
Other
Enumeration date
06/03/2025
Last updated
06/03/2025
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