1154268399 NPI number — TWO RIVERS HEALTH, NURSE PRACTITIONER IN PSYCHIATRY AND FAMILY HEALTH, PLLC

Table of content: (NPI 1154268399)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154268399 NPI number — TWO RIVERS HEALTH, NURSE PRACTITIONER IN PSYCHIATRY AND FAMILY HEALTH, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TWO RIVERS HEALTH, NURSE PRACTITIONER IN PSYCHIATRY AND FAMILY HEALTH, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
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Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
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Provider Other Last Name:
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NPI Number Information

NPI Number:
1154268399
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/04/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4795 COMMERCIAL DR # 1011
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW HARTFORD
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13413-6211
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
315-557-8193
Provider Business Mailing Address Fax Number:
315-300-1347

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18 JOHN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOHAWK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13407-1404
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-557-8193
Provider Business Practice Location Address Fax Number:
315-300-1347
Provider Enumeration Date:
05/04/2026

Additional Information

Authorized Official

Authorized Official Last Name:
WINTLE
Authorized Official First Name:
BRITTIE
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/PMHNP
Authorized Official Telephone Number:
315-527-6755

Provider Taxonomy Codes

  • Taxonomy code: 363LP0808X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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