Organization
ALBATROSS TO PHOENIX PSYCHIATRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICKY JAMES JEWELL APN (ADVANCED PRACTICE NURSE)
(862) 774-4562
Entity
Organization
Contact information
Practice address
111 TOWN SQUARE PL STE 1238, JERSEY CITY, NJ 07310-1810
(201) 757-2531
Mailing address
111 TOWN SQUARE PL, SUITE 1238 PMB 801874, JERSEY CITY, NJ 07310
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/19/2024
Last updated
02/19/2024
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