Organization
DESTA ANTHONY MOBILE NP ADULT HEALTH, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DESTA ROWENA ANTHONY (OWNER)
(315) 559-1965
Entity
Organization
Contact information
Practice address
8241 PENSTOCK WAY, MANLIUS, NY 13104-9401
(315) 413-3848
(315) 692-4292
Mailing address
8241 PENSTOCK WAY, MANLIUS, NY 13104-9401
(315) 559-1965
(833) 606-0692
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/09/2020
Last updated
11/28/2025
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