Individual
MARTINE MBIAKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
45 E DOVER ST, VALLEY STREAM, NY 11580-4105
(718) 828-2666
Mailing address
45 E DOVER ST, VALLEY STREAM, NY 11580-4105
(718) 828-2666
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
620778
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F406053
NY
Other
Enumeration date
01/16/2023
Last updated
11/25/2025
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