Canaan Psychiatric and Addiction Services LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

CANAAN PSYCHIATRIC AND ADDICTION SERVICES LLC

Practice address

4377 Bronx Blvd
Bronx, NY 10466-1397

Phone

(347) 912-7566

Fax

(646) 490-8780

NPI assigned

Oct 19, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Kevin Obi, PSYCHIATRIC NPNPI 1679062640

Title

Authorized Official

Phone

(973) 342-5593

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kevin Obi

  • Psychiatric/Mental Health Nurse Practitioner
  • Union, NJ
  • NPI 1679062640
  NPD Authorized official

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

{
    "created_epoch": "1634601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634601600000",
    "number": "1063175818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 ELKER RD",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070835006",
            "telephone_number": "347-912-7566",
            "fax_number": "646-490-8780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4377 BRONX BLVD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104661397",
            "telephone_number": "347-912-7566",
            "fax_number": "646-490-8780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANAAN PSYCHIATRIC AND ADDICTION SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-19",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A",
        "authorized_official_last_name": "OBI",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "973-342-5593",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PSYCHIATRIC NP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5427909",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kiana Campozano
• Joannie Campuzano Cepeda, L.AC
• Hector Campuzano
• Jorge Luis Camunas, M.D.
• Canaan Medical LLC
• Tanequa Canady
• Michelle Canales, REGISTER NURSE
• Jacob Daniel Canavan, MD
• Angela Cancel, LCSW
• David Cancel, M.D., J.D.

• Psychiatric/Mental Health Nurse Practitioner in Bronx, NY
• Providers in Bronx, 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 Oct 19, 2021; 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.