Individual
LARISSA JEROMINOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
F30911-01
NY
363LA2200X
Adult Health Nurse Practitioner
APRN11026210
FL
363LG0600X
Gerontology Nurse Practitioner
Primary
F309311-01
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06209916
—
NY
01
—
1205559812
NURSE PRACTITIONER-ADULT GERONTOLOGY
—
Enumeration date
09/14/2019
Last updated
06/11/2026
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