Individual
MRS. VANESSA A MENJIVAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
750 ASTOR AVE, BRONX, NY 10467
(718) 882-5000
Mailing address
1019 SOUTHERN BLVD APT 3D, BRONX, NY 10459-3499
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
22-719661
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F402398-1
NY
Other
Enumeration date
07/02/2017
Last updated
06/26/2018
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