- Practice location
- 230 Park Ave Fl 3, New York, NY 10169-0018
- Phone
- 516-505-7200
- Fax
- 949-419-3482
- Last updated
- August 14, 2022
Bryan Lackey is a Nurse Practitioner, Psych/Mental Health based in New York, NY. Bryan Lackey practices in New York, NY and has the professional credentials of PMHNP-BC. The NPI Number for Bryan Lackey is 1891305645 and holds a License No. 26NJ01045800 (NJ). The current practice location address for Bryan Lackey is 230 Park Ave Fl 3, New York, NY 10169-0018 and can be reached out via phone at 516-505-7200 and via fax at 949-419-3482.
Provider Profile Details
- NPI Number
- 1891305645
- Provider Name
- Bryan Lackey
- Credential
- PMHNP-BC
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 230 Park Ave Fl 3, New York, NY 10169-0018
- Phone Number
- 516-505-7200
- Fax Number
- 949-419-3482
- Primary Taxonomy
- Nurse Practitioner, Psych/Mental Health · 363LP0808X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- August 6, 2020
- Last Update Date
- August 14, 2022
- Certification Date
- August 14, 2022
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 230 Park Ave Fl 3
New York, NY 10169-0018 - City
- New York
- State
- New York
- Zip
- 10169-0018
- Phone Number
- 516-505-7200
- Fax Number
- 949-419-3482
Provider Business Mailing Address Details
- Address
- 230 Park Ave Fl 3
New York, NY 10169-0018 - City
- New York
- State
- NY
- Zip
- 10169-0018
- Phone Number
- 347-861-6651
- Fax Number
- 949-419-3482
License Information
- License Number (1)
- 26NJ01045800
- License State (1)
- NJ
- Taxonomy (1)
- Nurse Practitioner, Psych/Mental Health · 363LP0808X
- License Number (2)
- 403117
- License State (2)
- NY
- Taxonomy (2)
- 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 Bryan Lackey, PMHNP-BC?
The NPI number of Bryan Lackey, PMHNP-BC is 1891305645. It was assigned on August 6, 2020 and is currently active in the NPPES registry.
What is the specialty of Bryan Lackey, PMHNP-BC?
Bryan Lackey, PMHNP-BC is registered under the primary taxonomy Nurse Practitioner, Psych/Mental Health (code 363LP0808X), licensed in NJ under license number 26NJ01045800.
Where does Bryan Lackey, PMHNP-BC practice?
The practice location is 230 Park Ave Fl 3, New York, NY 10169-0018. The office can be reached at 516-505-7200 (phone) or 949-419-3482 (fax).
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 1891305645 directly on the NPPES registry website.