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Individual

JOSHTIN DALE ORDONA SULSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(212) 639-2000
Mailing address
7819 91ST AVE, WOODHAVEN, NY 11421-2935
(347) 401-0718

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
777310
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
312074
NY

Other

Enumeration date
07/07/2025
Last updated
08/22/2025
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