Organization
EMERGING PATH NURSE PRACTITIONER IN PSYCHIATRY, PC
Active
Other names
EMERGING PATH NURSE PRACTITIONER IN
Organization subpart
No
Provider details
NPI number
Authorized official
TINA DANTONIO (OFFICE MANAGER)
(631) 629-2879
Entity
Organization
Contact information
Practice address
315 WALT WHITMAN RD STE 210, HUNTINGTON STATION, NY 11746-4112
(631) 629-2879
(949) 864-3515
Mailing address
315 WALT WHITMAN RD STE 210, HUNTINGTON STATION, NY 11746-4112
(631) 629-2879
(949) 864-3515
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/25/2025
Last updated
08/27/2025
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