Individual
MS. SUSAN MARTA DELISLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.N.P., PMHNP
Contact information
Practice address
516 W 168TH ST FL 1, NEW YORK, NY 10032-4103
(122) 326-5705
Mailing address
516 W 168TH ST FL 1, NEW YORK, NY 10032-4103
(122) 326-5705
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
F304323-1
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
402436
NY
Other
Enumeration date
07/19/2006
Last updated
01/25/2019
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