Individual
ITISHA WASHINGTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1622 CENTRAL AVE, FAR ROCKAWAY, NY 11691-4002
(718) 327-9001
Mailing address
505 E 45TH ST, BROOKLYN, NY 11203-4105
(917) 216-7004
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
738577
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
405660
NY
Other
Enumeration date
07/06/2020
Last updated
04/07/2024
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