Individual
MS. IMMACULATE PRASADANI DESILVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C, MPH
Contact information
Practice address
332 E 14TH ST, NEW YORK, NY 10003-4243
(212) 481-3333
Mailing address
332 E 14TH ST, NEW YORK, NY 10003-4243
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
028850
NY
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
05/26/2020
Last updated
09/27/2024
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