Eboni Renee Wyllie

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

407883 Issued in NY

Practice address

33 W 60TH St
New York, NY 10023-7905

Phone

(212) 227-6100

NPI assigned

Feb 27, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1677456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1033818331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 RIDGLEY ST",
            "city": "HACKETTSTOWN",
            "state": "NJ",
            "postal_code": "078403452",
            "telephone_number": "347-668-5351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 W 60TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100237905",
            "telephone_number": "212-227-6100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1719 NJ-10",
            "address_2": "Suite 129",
            "address_purpose": "LOCATION",
            "city": "Parsippany",
            "state": "NJ",
            "postal_code": "07054",
            "country_code": "US",
            "telephone_number": "973-829-6960",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15 Ridgley St",
            "address_purpose": "LOCATION",
            "city": "Hackettstown",
            "state": "NJ",
            "postal_code": "078403452",
            "country_code": "US",
            "telephone_number": "347-668-5351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYLLIE",
        "first_name": "EBONI",
        "middle_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-27",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "407883",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ15081700",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "383395",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wyckoff Heights Medical Center
• Matthew Wyckoff, M.D.
• Joyce Diane Wyden, PHD
• Peter Charles Wyer, MD
• Jason J Wyland, PA
• Norman Howard Wyloge, PH.D, LCSW
• Makayla Wyly
• Herbert M Wyman, M.D.
• Neila Cohalan Wyman, LCSW, PA
• Eva F Wyner, MA, CCC-SLP

• Psychiatric/Mental Health Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.