- Practice location
- 65 E Maltbie Ave, Suffern, NY 10901-6007
- Phone
- 901-590-7680
- Fax
- —
- Last updated
- November 17, 2020
Fatima Odetalla is a Nurse Practitioner, Psych/Mental Health based in Suffern, NY. Fatima Odetalla practices in Suffern, NY and has the professional credentials of DNP, FNP/PMHNP-BC. The NPI Number for Fatima Odetalla is 1881005478 and holds a License No. f338723 (NY). The current practice location address for Fatima Odetalla is 65 E Maltbie Ave, Suffern, NY 10901-6007 and can be reached out via phone at 901-590-7680.
Provider Profile Details
- NPI Number
- 1881005478
- Provider Name
- Fatima Odetalla
- Credential
- DNP, FNP/PMHNP-BC
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 65 E Maltbie Ave, Suffern, NY 10901-6007
- Phone Number
- 901-590-7680
- Primary Taxonomy
- Nurse Practitioner, Psych/Mental Health · 363LP0808X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- May 16, 2014
- Last Update Date
- November 17, 2020
- Certification Date
- November 13, 2020
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 65 E Maltbie Ave
Suffern, NY 10901-6007 - City
- Suffern
- State
- New York
- Zip
- 10901-6007
- Phone Number
- 901-590-7680
Provider Business Mailing Address Details
- Address
- 65 E Maltbie Ave
Suffern, NY 10901-6007 - City
- Suffern
- State
- NY
- Zip
- 10901-6007
- Phone Number
- 901-590-7680
License Information
- License Number (1)
- f338723
- License State (1)
- NY
- Taxonomy (1)
- Nurse Practitioner, Family · 363LF0000X
- License Number (2)
- 18374
- License State (2)
- TN
- Taxonomy (2)
- Nurse Practitioner, Family · 363LF0000X
- License Number (3)
- 18374
- License State (3)
- TN
- Taxonomy (3)
- Nurse Practitioner, Psych/Mental Health · 363LP0808X
- License Number (4)
- f401694
- License State (4)
- NY
- Taxonomy (4)
- Nurse Practitioner, Psych/Mental Health · 363LP0808X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Dr. Fatima Odetalla, DNP, FNP/PMHNP-BC?
The NPI number of Dr. Fatima Odetalla, DNP, FNP/PMHNP-BC is 1881005478. It was assigned on May 16, 2014 and is currently active in the NPPES registry.
What is the specialty of Dr. Fatima Odetalla, DNP, FNP/PMHNP-BC?
Dr. Fatima Odetalla, DNP, FNP/PMHNP-BC is registered under the primary taxonomy Nurse Practitioner, Psych/Mental Health (code 363LP0808X), licensed in NY under license number f338723.
Where does Dr. Fatima Odetalla, DNP, FNP/PMHNP-BC practice?
The practice location is 65 E Maltbie Ave, Suffern, NY 10901-6007. The office can be reached at 901-590-7680 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1881005478 directly on the NPPES registry website.