Individual
MRS. JOHANNA ROSE YACONO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3104 QUENTIN RD, BROOKLYN, NY 11234-4200
(718) 339-5544
Mailing address
2059 E 71ST ST, BROOKLYN, NY 11234-6242
(917) 691-2989
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
383164
NY
Other
Enumeration date
08/11/2021
Last updated
08/12/2021
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