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Individual

JOANNE DESIRE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
119 NASSAU AVE, FREEPORT, NY 11520-5518
(516) 298-7603
Mailing address
119 NASSAU AVE, FREEPORT, NY 11520-5518
(516) 298-7603

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
420776
NY

Other

Enumeration date
12/11/2020
Last updated
12/11/2020
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