Dynamic Mental Health Services, LLC
Nurse Practitioner, Psych/Mental Health in Old Tappan, NJ. Organization (NPI-2).
NPI number1669337705
StatusActive
Last updated in NPPESMay 22, 2026
Details
- NPI
- 1669337705
- Entity type
- Organization (NPI-2)
- Legal business name
- Dynamic Mental Health Services, LLC
- Organization subpart
- No
- Enumeration date
- Dec 22, 2025
- Certification date
- May 22, 2026
- Last updated
- May 22, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – | Yes |
Practice location
48 Bi State Plz # 841Old Tappan, NJ 07675-7003
Phone 917-383-3750
Mailing address
48 Bi State PlzPmb841
Old Tappan, NJ 07675-7003
Phone 917-383-3750
Authorized official
Ezinne Ezete
Managing Member
9173833750
Is something wrong?
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