Provider Demographics
NPI:1528727757
Name:ALTIMATE NP HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:ALTIMATE NP HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOATENG-WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:917-488-7910
Mailing Address - Street 1:3403 ROPES AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-1016
Mailing Address - Country:US
Mailing Address - Phone:917-488-7910
Mailing Address - Fax:
Practice Address - Street 1:547 NORTH AVE
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-2601
Practice Address - Country:US
Practice Address - Phone:917-488-7910
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-15
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth ServiceGroup - Multi-Specialty