Individual provider · Type 1 NPI
Supaporn Pathumanon, PMHNP
Psychiatric/Mental Health Nurse Practitioner · Larchmont, NY
NPI number
1477243392
Active
Practice location
814 Larchmont Acres Apt D
Larchmont, NY 10538-7370
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | F406141-01 (NY) |
| Registered Nurse | 163W00000X | 738012 (NY) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
Another provider at this address
About NPI 1477243392
Supaporn Pathumanon, PMHNP's National Provider Identifier is 1477243392, issued on May 12, 2023. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Larchmont, NY. The record was last updated on Mar 16, 2026.