Organization
CARBON MINDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT TERRELONGE (CEO)
(347) 755-5214
Entity
Organization
Contact information
Practice address
95 DARTMOUTH ST, VALLEY STREAM, NY 11581-3215
(347) 755-5214
Mailing address
95 DARTMOUTH ST, VALLEY STREAM, NY 11581-3215
(347) 755-5214
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/26/2019
Last updated
06/26/2019
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