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

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

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
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

Other providers in Boston, MA

All providers in Boston, MA · Psychiatric/Mental Health Nurse Practitioner in Massachusetts

Sources for this page

Verify at the official NPI Registry.