Individual
LIANDRA WAISOME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1 PENN PLZ, SUITE 725, NEW YORK, NY 10119-0002
(917) 364-0995
Mailing address
1 PENN PLZ, SUITE 725, NEW YORK, NY 10119-0002
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
306370
NY
363L00000X
Nurse Practitioner
340897
NY
Other
Enumeration date
04/16/2013
Last updated
04/16/2013
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