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Individual

LATISHA MYRIE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1309 FULTON AVE FL 2, BRONX, NY 10456-2403
(917) 932-4917
Mailing address
7520 ASTORIA BLVD STE 250, EAST ELMHURST, NY 11370-1131
(917) 932-4917

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
357268
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
403968
NY

Other

Enumeration date
01/21/2022
Last updated
04/21/2026
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