Organization
MY PSYCH PROVIDER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL OKECHUKWU APN, PMHNP (PSYCHIATRIC NURSE PRACTITIONER)
(973) 791-9365
Entity
Organization
Contact information
Practice address
100 ENTERPRISE DR STE 301, ROCKAWAY, NJ 07866-2129
(973) 791-9365
(973) 869-2449
Mailing address
100 ENTERPRISE DR STE 301, ROCKAWAY, NJ 07866-2129
(973) 791-9365
(973) 869-2449
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/21/2023
Last updated
11/29/2023
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