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Individual

MISS JOHANNA VICTORIA GRIMALDI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1468 MADISON AVE, NEW YORK, NY 10029-6508
(212) 241-6500
Mailing address
1600 HARBOR BLVD APT 1415W, WEEHAWKEN, NJ 07086-6881
(716) 491-5594

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR20140300
NJ
163W00000X
Registered Nurse
748106
NY
363LA2100X
Acute Care Nurse Practitioner
Primary
432189
NY
363LA2100X
Acute Care Nurse Practitioner
F432189
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
07250333
NY
Enumeration date
12/06/2021
Last updated
05/13/2023
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