Provider Demographics
NPI:1144950890
Name:FRONTIER NP PSYCHIATRIC SERVICES PLLC
Entity type:Organization
Organization Name:FRONTIER NP PSYCHIATRIC SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:CARLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMOUR-OCCEAN
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:929-452-1588
Mailing Address - Street 1:1506 E 54TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-3930
Mailing Address - Country:US
Mailing Address - Phone:347-247-9588
Mailing Address - Fax:
Practice Address - Street 1:1975 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-4404
Practice Address - Country:US
Practice Address - Phone:646-530-2336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-15
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty