Provider Demographics
NPI:1023720893
Name:REACHING MINDS NP IN PSYCHIATRY AND ADULT HEALTH P.C
Entity type:Organization
Organization Name:REACHING MINDS NP IN PSYCHIATRY AND ADULT HEALTH P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COE
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:OGHALE
Authorized Official - Last Name:IGBIDE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:917-651-8465
Mailing Address - Street 1:319 HEMPSTEAD AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-2042
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:319 HEMPSTEAD AVE
Practice Address - Street 2:
Practice Address - City:WEST HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11552-2042
Practice Address - Country:US
Practice Address - Phone:516-907-9243
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-23
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04785897Medicaid