Individual
MARIA CARMELA YU SAM EVANGELISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
622 W 168TH ST, PH 11, NEW YORK, NY 10032-3720
(212) 305-1566
(212) 305-1457
Mailing address
622 W 168TH ST, PH 11, NEW YORK, NY 10032-3720
(212) 305-1566
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
304724
NY
363LA2200X
Adult Health Nurse Practitioner
263257
MA
363LA2200X
Adult Health Nurse Practitioner
Primary
304724
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
304724
NY STATE NP REGISTRATION
NY
Enumeration date
09/27/2007
Last updated
12/20/2023
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