Provider Demographics
NPI:1538896618
Name:SQUARE HEALTH SERVICES NP IN PSYCHIATRY, PLLC
Entity type:Organization
Organization Name:SQUARE HEALTH SERVICES NP IN PSYCHIATRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:FERDOUSI
Authorized Official - Middle Name:
Authorized Official - Last Name:BEGUM
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:718-433-9333
Mailing Address - Street 1:7514 37TH AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-6538
Mailing Address - Country:US
Mailing Address - Phone:718-433-9333
Mailing Address - Fax:718-433-9445
Practice Address - Street 1:7514 37TH AVE
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-6538
Practice Address - Country:US
Practice Address - Phone:718-433-9333
Practice Address - Fax:718-433-9445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty