Michael Henry Bolus, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

401420 Issued in NY

Practice address

451 Clarkson Ave
Brooklyn, NY 11203-2054

Phone

(718) 245-3131

NPI assigned

Oct 24, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1319414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319414400000",
    "number": "1598041501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1113 E 73RD ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112345400",
            "telephone_number": "718-763-5633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 CLARKSON AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032054",
            "telephone_number": "718-245-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLUS",
        "first_name": "MICHAEL",
        "middle_name": "HENRY",
        "name_prefix": "Mr.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-24",
        "last_updated": "2011-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "401420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gulmira Boltaeva
• Shoshana Bolthauser
• Elisha Dawn Bolton, LPN
• Kay A Bolton, MS. SP ED
• Martin J Bolton, PH.D.
• Heather Boman
• Victoria Marie Bombe, CTRS
• Pasquale A Bombino, BC-HIS
• Olga Bomko
• Naomi Bomrind, MA

• Psychiatric/Mental Health Nurse Practitioner in Brooklyn, NY
• Providers in Brooklyn, 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 24, 2011; 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.