Individual provider · Type 1 NPI
Johvani E. Bantiles
Child & Adolescent Psychiatric/Mental Health Registered Nurse · Watertown, NY
NPI number
1770332280
Active
Practice location
650 State St
Watertown, NY 13601-2839
Fax (315) 291-6601
Mailing address
720 Mill St Apt 1
Watertown, NY 13601-1566
Other practice locations
- 1 Chimney Point Dr, Ogdensburg, NY 13669-2212 · (315) 775-7649
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Child & Adolescent Psychiatric/Mental Health Registered Nurse Primary | 163WP0807X | 915663 (NY) |
Child & Adolescent Psychiatric/Mental Health Registered Nurse: Definition to come...
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About NPI 1770332280
Johvani E. Bantiles's National Provider Identifier is 1770332280, issued on May 16, 2024. The primary taxonomy on file is Child & Adolescent Psychiatric/Mental Health Registered Nurse (163WP0807X), and the practice location is in Watertown, NY. The record was last updated on Oct 3, 2024.