Individual
JORDA PISKULOSKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
113 E 39TH ST # 115, NEW YORK, NY 10016-0968
(212) 223-0716
Mailing address
2470 ROSSETT ST, FORT LEE, NJ 07024-3918
(973) 713-8199
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F3081171
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9666558
NURSE PRACTITIONER CERTIFICATE NUMBER
NY
Enumeration date
02/25/2018
Last updated
02/25/2018
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