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Organization

PAVEL ODINTSOV NP IN ADULT HEALTH PLLC

Active
Parent organization
PAVEL ODINTSOV NP IN ADULT HEALTH AND PSYCHIATRY
Other names
PAVEL ODINTSOV NP IN ADULT HEALTH PLLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
PAVEL ODINTSOV NP IN ADULT HEALTH AND PSYCHIATRY
Authorized official
PAVEL ODINTSOV ADULT-NP., PMHNP. (OWNER/NURSE PRACTITIONER)
(201) 665-4150
Entity
Organization

Contact information

Practice address
182 S MAIN ST STE 106, NEW CITY, NY 10956-3318
(845) 358-4000
Mailing address
297 HILLSDALE AVE, HILLSDALE, NJ 07642-2212
(201) 665-4150

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
363LA2200X
Adult Health Nurse Practitioner
Primary
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
363LP2300X
Primary Care Nurse Practitioner

Other

Enumeration date
08/06/2024
Last updated
08/06/2024
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