Individual
CHRISTIAN JOSE PLAZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
407 GIDNEY AVE STE B, NEWBURGH, NY 12550-3741
(845) 561-7075
(845) 561-7006
Mailing address
407 GIDNEY AVE STE B, NEWBURGH, NY 12550-3741
(845) 561-7075
(845) 561-7006
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
343284
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
F405130
NY
Other
Enumeration date
07/19/2018
Last updated
10/19/2023
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