ILLUMINATE NP PSYCHIATRY NPI 1871184424

NPI Information

ILLUMINATE NP PSYCHIATRY is a psychiatric/mental health nurse practitioner in Orchard Park, NY. ILLUMINATE NP PSYCHIATRY NPI is 1871184424. The provider is registered as an organization entity type.
The provider Other Name Is Illuminate Np Psychiatry, Pllc.

The provider's business location address is:

3055 SOUTHWESTERN BLVD STE 110
ORCHARD PARK, NY
ZIP 14127-231
Phone: (716) 903-6036
Fax: (716) 463-2225

The provider's authorized official is Amy Kotarski .
The authorized official title is Owner and has the following contact phone number (716) 903-6036.

The enumeration date for this NPI number is 1/27/2021 and was last updated on 3/6/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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