Basic Information
| Provider Information | |||||||||
| NPI: | 1568886380 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | INTEGRATED NEUROPSYCHIATRY NURSE PRACTITIONER (INNP) P C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10 ANN ST | ||||||||
| Address2: | |||||||||
| City: | SAUGERTIES | ||||||||
| State: | NY | ||||||||
| PostalCode: | 124771804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8455322493 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10 ANN ST | ||||||||
| Address2: | |||||||||
| City: | SAUGERTIES | ||||||||
| State: | NY | ||||||||
| PostalCode: | 124771804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8455322493 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/13/2014 | ||||||||
| LastUpdateDate: | 07/21/2015 | ||||||||
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| AuthorizedOfficialLastName: | MCGREGOR | ||||||||
| AuthorizedOfficialFirstName: | VICTOR | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8455322493 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | PHD, NP | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | 400138 | NY | Y | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.