Individual
ANTHONY KEALA HAVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN, NP
Contact information
Practice address
109 E 115TH ST, NEW YORK, NY 10029-1186
(541) 206-3529
Mailing address
312 CHATEAU RIVE, PEEKSKILL, NY 10566-2166
(541) 206-3529
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
758196
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
403148
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
758196
RN LICENSE
NY
Enumeration date
10/03/2019
Last updated
11/19/2025
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