| Provider / Organization | NPI | Date Certified |
|---|---|---|
| JEFFREY M PANKO | 1497469860 | 2024-11-10 |
Jeffrey M Panko is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1497469860. Registration indicates Jeffrey M Panko is a provider of access to mental health/behavioral health providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner: Psych/Mental Health, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner Psych/Mental Health, Physician Assistants & Advanced Practice Nursing Providers) (Nurse Practitioner, )
| Entity Type | Individual |
| Provider Name | Jeffrey M Panko PMHNP-BC |
| Practice Office Address | 5911 23RD AVE BROOKLYN, NY US |
| Practice Office Telephone | 6464794522 |
| Practice Office Fax | 9792709082 |
| Mailing Address | 5911 23RD AVE BROOKLYN, NY 112042602 US |
| Business Telephone | 6465495694 |
| Business Fax | 9792709082 |
| Code | Practice | License No State |
|---|---|---|
| 363LP0808X PRIMARY | Access to Mental Health/Behavioral Health Providers Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Nurse Practitioner: Psych/Mental Health All Other Specialties & Provider Types Nurse Practitioner Psych/Mental Health Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | 406127
NY |