Individual
ROMI LYALLPURI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
274 MADISON AVE RM 1501, NEW YORK, NY 10016-0701
(212) 203-1773
Mailing address
23 CALDWELL RD, VALLEY STREAM, NY 11580-1911
(631) 645-3608
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
856776-01
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
405993-01
NY
Other
Enumeration date
11/23/2022
Last updated
01/02/2025
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