Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Great Water Land Services Nurse Practitioner in Psychiatry PLLC

Organization Psychiatric/Mental Health Nurse Practitioner · NPI 1386463040

Great Water Land Services Nurse Practitioner in Psychiatry PLLC is a Psychiatric/Mental Health Nurse Practitioner in Massapequa, New York. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

166 Euclid Ave
Massapequa, NY 11758-4207
Phone: (516) 695-0389
Fax: (956) 253-4627
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X

Record details

NPI number1386463040
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jill Ryan — Nurse Practitioner · (516) 695-0389
NPI enumeratedOctober 8, 2024
Last updated in NPPESOctober 8, 2024
Certification dateOctober 8, 2024
Mailing address166 Euclid Ave, Massapequa, NY 11758-4207

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