Organization
HEALTHY MINDS WNY L.L.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN YUDHISTIRA PMHNP (PSYCHIATRIC NURSE PRACTITIONER)
(347) 229-3939
Entity
Organization
Contact information
Practice address
4498 MAIN ST STE 4, BUFFALO, NY 14226-3826
(716) 451-3600
Mailing address
4498 MAIN ST STE 4, BUFFALO, NY 14226-3826
(716) 451-3600
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/20/2022
Last updated
09/20/2022
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