Individual
ANTOINETTE MARIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1019 E WATER ST, ELMIRA, NY 14901-3332
(607) 733-5696
Mailing address
1019 E WATER ST, ELMIRA, NY 14901-3332
(607) 733-5696
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
621471
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
1578240
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
403621
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04978007
—
NY
Enumeration date
10/14/2015
Last updated
11/12/2025
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