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Individual

MISS EMBER NICOLE DESTEFANI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-BC

Contact information

Practice address
1824 MADISON AVE, NEW YORK, NY 10035-3832
(212) 423-4500
Mailing address
1824 MADISON AVE, NEW YORK, NY 10035-3832
(212) 423-4500

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F337111-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
F337111
LICENSE
NY
Enumeration date
07/05/2012
Last updated
01/03/2020
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