Individual
MARTHA NAHUESENAY DESTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
505 E 70TH ST, NEW YORK, NY 10021-4872
(646) 673-5885
Mailing address
505 E 70TH ST, NEW YORK, NY 10021-4872
(646) 673-5885
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F341751-1
NY
Other
Enumeration date
12/10/2019
Last updated
12/10/2019
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