Individual
DIANA DENISOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
135 SEA BREEZE AVE, APT 205, BROOKLYN, NY 11224-3700
(917) 848-3128
Mailing address
135 SEA BREEZE AVE, APT 205, BROOKLYN, NY 11224-3700
(917) 848-3128
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F306811
NY
363LG0600X
Gerontology Nurse Practitioner
F340939
NY
Other
Enumeration date
08/15/2014
Last updated
08/15/2014
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