Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Erewarifagha Minini Haidome, PMHNP-BC

Individual provider Registered Nurse · NPI 1114301728

Mrs. Erewarifagha Minini Haidome, PMHNP-BC is a Nurse Practitioner in Jamaica, New York. Qualified in 2021, 5 years ago. Practices with Shakespeare Operating LLC, a 137-clinician group, works from 3 locations, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
5
Licensed in
NY
In the registry since
2015
Specialties on file
2
What do these letters mean?
PMHNP-BC — Psychiatric-Mental Health Nurse Practitioner, Board Certified
A board-certified psychiatric nurse practitioner.

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Practice location Address checks out

14036 170th St
Jamaica, NY 11434-4632
Phone: (347) 843-7760
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 391 E 149th St Rm 405, Bronx, NY 10455-3907 — (718) 215-1117
  • 256 Washington St, Mount Vernon, NY 10553-1052 — (914) 613-0700

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 403564 (NY)
Registered Nurse Taxonomy 163W00000X · Licence 621055-1 (NY)

Record details

NPI number1114301728
Entity typeIndividual (Type 1)
GenderFemale
Credentials PMHNP-BC
Sole proprietorNo
NPI enumeratedJuly 13, 2015
Last updated in NPPESNovember 2, 2023
Certification dateNovember 2, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Shakespeare Operating Llc — 137 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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