Individual
JANINE DESIMONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NPP
Contact information
Practice address
47 ROUTE 25A, SETAUKET, NY 11733-2881
(631) 780-4103
(631) 250-9215
Mailing address
7 BRASSWOOD RD, SAINT JAMES, NY 11780-3411
(631) 921-1949
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
40 401937
NY
390200000X
Student in an Organized Health Care Education/Training Program
475699-1
NY
Other
Enumeration date
09/30/2014
Last updated
06/27/2022
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