Individual
MS. JEANNA M DESISTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
1468 MADISON AVE, NEW YORK, NY 10029-6508
(212) 241-6500
Mailing address
42 LAUDATEN WAY, WARWICK, NY 10990-3835
(347) 628-2277
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
F432777
NY
Other
Enumeration date
11/06/2023
Last updated
11/06/2023
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