Organization
YOGATASTIC
Active
Other names
yogatastic, LI Comprehesive Psychiatry PC
Organization subpart
No
Provider details
NPI number
Authorized official
AMALIA PER NP (NP)
(917) 306-6054
Entity
Organization
Contact information
Practice address
106 PARK BLVD, MALVERNE, NY 11565-1717
(917) 306-6054
Mailing address
106 PARK BLVD, MALVERNE, NY 11565-1717
(917) 306-6054
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
081181999
PSYCH
—
05
—
08181999
—
NY
Enumeration date
10/02/2024
Last updated
10/02/2024
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