Individual
JESSICA STILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
26901 76TH AVE, 4TH FLOOR, NEW HYDE PARK, NY 11040-1433
(718) 470-3140
Mailing address
395 S END AVE APT 25B, NEW YORK, NY 10280-1033
(203) 536-2295
Taxonomy
Speciality
Code
Description
License number
State
163WP0218X
Pediatric Oncology Registered Nurse
629734
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
382608
NY
Other
Enumeration date
07/10/2014
Last updated
11/11/2019
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