Organization
KRISTEN BRIODY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTEN BRIODY PMHNP-BC (PMHNP-BC)
(631) 666-1615
Entity
Organization
Contact information
Practice address
107 W MAIN ST, EAST ISLIP, NY 11730-2337
(631) 666-1615
Mailing address
107 W MAIN ST, EAST ISLIP, NY 11730-2337
(631) 666-1615
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123456789
—
NY
Enumeration date
03/18/2022
Last updated
03/18/2022
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