DUSTIN BRADFORD VON HOLTEN (NPI# 1841720521) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841720521 |
| Entity Type | Individual |
| Full Name | DUSTIN BRADFORD VON HOLTEN |
| Credential | PMHNP |
| Practice Address |
555 Bergen Ave Fl 4 Bronx NY 10455-1368 |
| Practice Telephone | 7187428550 |
| Practice Fax Number | 7187428790 |
| Mailing Telephone | 7187428550 |
| Mailing Fax Number | 7187428790 |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2018-11-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
717042 | NY | Nursing Service Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
402408 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 560 Southern Blvd, Bronx, NY 104553715 | 7185851010 | |
| 630 W 168th St, New York, NY 100323725 | 6309230485 |
| Street Address |
555 BERGEN AVE FL 4 |
| City | BRONX |
| State | NY |
| Zip Code | 10455-1368 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487286449 | Luz Raquel Rivera | Registered Nurse | 555 Bergen Ave Fl 4, Bronx, NY 10455-1368 | 2020-02-07 |
| 1144852450 | Tonya Gilliam | Pediatrics | 555 Bergen Ave Fl 4, Bronx, NY 10455-1368 | 2020-02-05 |
| 1255963567 | Maria Cristina Moffitt | Licensed Practical Nurse | 555 Bergen Ave Fl 4, Bronx, NY 10455-1368 | 2020-02-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255946331 | Nutrished Dietitian Nutrition Solutions, P.C. | Dietitian, Registered | 2825 Third Ave Suite #301, Bronx, NY 10455 | 2020-09-15 |
| 1538641907 | Michelle Flores | Pharmacy Technician | 754 E 151 St, Bronx, NY 10455 | 2018-09-03 |
| 1669973285 | Uhc Adult Day Program & Transportation Services, Inc | Non-emergency Medical Transport (VAN) | 368, East 149th Street Suite 3a, Bronx, NY 10455 | 2018-02-28 |
| 1578061206 | Ursula Ma Stafford | Case Management | 391 East 149 St, Suite 417, Bronx, NY 10455 | 2018-01-29 |
| 1942714506 | Chantal J George | Case Manager/Care Coordinator | 391 East 149th Street, 417, Bronx, NY 10455 | 2017-11-18 |
| 1598295800 | Sonrisa Corp | Pharmacy | 755b East 149th St, Bronx, NY 10455 | 2017-06-19 |
| 1962931378 | Josepjh Appau | Licensed Practical Nurse | 512 Jackson Avenue, Apt 2a, Bronx, NY 10455 | 2017-06-08 |
| 1295187664 | Leticia Robles | Social Worker | 480 Concord Avenue Apt#3j, Bronx, NY 10455 | 2016-07-08 |
| 1811350242 | Jenna Medical Office PC | Family Medicine | 2742 Third Avenue, Bronx, NY 10455 | 2016-04-02 |
| 1841656857 | Heracles Medical PC | Internal Medicine | 2825 Third Ave, Suite 7, Bronx, NY 10455 | 2016-01-06 |
| Find all providers in zip 10455 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033734355 | Ruth Alexandra Ayure-ortiz | Nurse Practitioner | 1832 Hone Ave, Bronx, NY 10461-1407 | 2020-06-11 |
| 1578187910 | Different Approach Therapy Inc. | Nurse Practitioner | 2727 Henry Hudson Pkwy Apt 208, Bronx, NY 10463-4740 | 2020-06-02 |
| 1023644218 | Canaan Medical LLC | Nurse Practitioner | 661 Cauldwell Ave, Bronx, NY 10455-1503 | 2020-03-19 |
| 1790332500 | Shakiya Mussington | Nurse Practitioner | 3446 Wickham Ave, Bronx, NY 10469-2629 | 2019-08-26 |
| 1376020065 | Clara Ampem-darko | Nurse Practitioner | 748 Jackson Ave Apt 3b, Bronx, NY 10456-7918 | 2018-07-25 |
| 1174071740 | Philippe K. Z. Bah | Nurse Practitioner | 2700 Hering Ave, Bronx, NY 10469-5321 | 2016-09-13 |
| 1275905994 | Reagan Obiozor Anusionwu Np Psychiatry Pllc | Nurse Practitioner | 548 Throgs Neck Expwy, Bronx, NY 10465 | 2015-10-21 |
| 1043696750 | Godwin Okpomo Sr. | Nurse Practitioner | 2962 Wickham Ave, Bronx, NY 10469-3324 | 2015-08-04 |
| 1306187059 | Patrick Akobeh Tigenoah | Nurse Practitioner | 739 E 242nd St, Apartment 4b, Bronx, NY 10470-1284 | 2013-03-05 |
| 1578850665 | Briana Tiffany Morrison | Nurse Practitioner | 3 Fordham Hill Oval, Apt # 7c, Bronx, NY 10468-4708 | 2011-07-08 |
| Find all providers in BRONX | ||||
Please comment or provide details below to improve the information on DUSTIN BRADFORD VON HOLTEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.