Organization · Type 2 NPI

Greenleaf Nurse Practitioner In Psychiatry, PLLC

Clinic/Center · Staten Island, NY

NPI number 1750242020 Active

Practice location

1110 South Ave Ste 100
Staten Island, NY 10314-3411

Call (646) 796-4676 Map

Mailing address

46 Lake Park Dr
Piscataway, NJ 08854-5171

Specialties and licenses

TaxonomyCodeLicense
Clinic/Center Primary 261Q00000XNone listed

Clinic/Center: A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

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About NPI 1750242020

Greenleaf Nurse Practitioner In Psychiatry, PLLC's National Provider Identifier is 1750242020, issued on Nov 18, 2025. The primary taxonomy on file is Clinic/Center (261Q00000X), and the practice location is in Staten Island, NY. The record was last updated on Apr 13, 2026.