Individual
DIEMMAI ILUSTRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
1315 YORK AVE, NEW YORK, NY 10021-5304
(212) 746-5789
(212) 746-8144
Mailing address
3030 MIDDLETOWN RD APT 3G, BRONX, NY 10461-5360
(832) 630-3354
Taxonomy
Speciality
Code
Description
License number
State
163WI0500X
Infusion Therapy Registered Nurse
Primary
673155
NY
Other
Enumeration date
02/06/2014
Last updated
02/06/2014
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