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Individual
VALESSA MESIDOR
Active
Individual
VALESSA MESIDOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
347927-01
NY
363LP2300X
Primary Care Nurse Practitioner
347927-01
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06885978
—
NY
01
—
347927
STATE LICENSE
NY
01
—
A400330312
MEDICARE
NY
Enumeration date
08/01/2021
Last updated
07/02/2024
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