Adullam Integrated Psychiatry
Organization Active NPI Psychiatric/Mental Health Nurse Practitioner · Boston, MA
NPI 1265288658 · NPPES record last updated Apr 25, 2024
Key facts
- NPI
- 1265288658
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- Legal business name
- ADULLAM INTEGRATED PSYCHIATRY
- Practice address
- 155 Federal St Ste 700
Boston, MA 02110-1727 - Phone
- (701) 610-1994
- NPI assigned
- Apr 25, 2024
- Organization subpart
- No
Authorized official
- Name
- Derick Yensila Ngoran
- Title
- Pmhnp-BC
- Phone
- (701) 610-1994
Practitioners 1
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner |
363LP0808X | Yes |
Addresses
Primary practice location
155 Federal St Ste 700
Boston, MA 02110-1727
Mailing address
155 Federal St Ste 700
Boston, MA 02110-1727
Phone (701) 610-1994
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 25, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.