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Individual

LIBIA ROSA FONSECA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
300 COMMUNITY DR, MANHASSET, NY 11030-3876
(786) 380-0816
Mailing address
14130 PERSHING CRES APT 1N, JAMAICA, NY 11435-1923
(786) 380-0816

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
F432435-01
NY
364SA2100X
Acute Care Clinical Nurse Specialist
811391-01
NY

Other

Enumeration date
08/08/2022
Last updated
01/18/2024
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