Individual
GERALDA PELISSIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
11206 WITTHOFF AVE, QUEENS VILLAGE, NY 11429-1821
(917) 653-8017
Mailing address
11206 WITTHOFF AVE, QUEENS VILLAGE, NY 11429-1821
(917) 653-8017
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F307114-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04274824
—
NY
Enumeration date
11/04/2014
Last updated
07/13/2021
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