Individual
ANNA S KANISHCHEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1 PENN PLZ, 8TH FLOOR, NEW YORK, NY 10119-0002
(917) 478-4838
Mailing address
19 STONE CREST CT, STATEN ISLAND, NY 10308-2170
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
336331
NY
Other
Enumeration date
06/19/2010
Last updated
09/16/2015
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