FATIMA ODETALLA NP IN PSYCHIATRY PLLC NPI 1639771744

NPI Information

NPI: 1639771744
Provider Name: FATIMA ODETALLA, NP IN PSYCHIATRY, PLLC
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

Address:
99 MAIN ST STE 302
NYACK, NY
ZIP 10960
Phone: (901) 590-7680
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FATIMA ODETALLA, NP IN PSYCHIATRY, PLLC is a psychiatric/mental health nurse practitioner in Nyack, NY. FATIMA ODETALLA, NP IN PSYCHIATRY, PLLC NPI is 1639771744. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

99 MAIN ST STE 302
NYACK, NY
ZIP 10960-109
Phone: (901) 590-7680

The provider's authorized official is Fatima Odetalla .
The authorized official title is Owner and has the following contact phone number (901) 590-7680.

The enumeration date for this NPI number is 11/13/2020 and was last updated on 11/13/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family			No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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