Organization
MOBILE ADULT NURSE PRACTITIONER SERVICES PLLC
Active
Other names
n/a
Organization subpart
No
Provider details
NPI number
Authorized official
LIANDRA WAISOME NP (CEO)
(917) 748-5699
Entity
Organization
Contact information
Practice address
66 MAIN ST APT 607, YONKERS, NY 10701-8854
(917) 748-5699
Mailing address
66 MAIN ST APT 607, YONKERS, NY 10701-8854
(917) 748-5699
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/24/2019
Last updated
10/24/2019
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