Individual
ALEX MUSTACHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
330 W 58TH ST, NEW YORK, NY 10019-1827
(978) 600-8314
Mailing address
29 OXFORD DR, MONTEBELLO, NY 10901-3955
(978) 600-8314
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
404472
NY
Other
Enumeration date
09/21/2022
Last updated
09/21/2022
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