Individual
DEEPTHI JOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-4321
Mailing address
1 THERESA LN, SCARSDALE, NY 10583-4621
(914) 573-1368
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F353536-01
NY
Other
Enumeration date
05/13/2024
Last updated
05/13/2024
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