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Individual

NINO JIAO TIBAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AGPCNP, NP-C

Contact information

Practice address
425 E 61ST ST, 4TH FLOOR, NEW YORK, NY 10065-8722
(646) 962-2333
Mailing address
425 E 61ST ST, 4TH FLOOR, NEW YORK, NY 10065-8722
(646) 962-2333

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
306389
NY
363LG0600X
Gerontology Nurse Practitioner
340903
NY

Other

Enumeration date
05/29/2013
Last updated
05/29/2013
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