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Organization

URBAN LIGHT PSYCHIATRIC NP PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. EDWARD K AFFUL NPP (MANAGER)
(347) 543-4726
Entity
Organization

Contact information

Practice address
180 S BROADWAY STE 406, WHITE PLAINS, NY 10605-1820
(347) 543-4726
(914) 222-8921
Mailing address
180 S BROADWAY STE 406, WHITE PLAINS, NY 10605-1820
(347) 543-4726
(914) 222-8921

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
05993242
NY
Enumeration date
12/07/2020
Last updated
11/04/2024
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