Individual
ANDRAEA KAMILLE MERCADO DIZON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
130 E 77TH ST FL 8, NEW YORK, NY 10075-1851
(212) 434-6400
Mailing address
130 E 77TH ST FL 8, NEW YORK, NY 10075-1851
(212) 434-6400
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F352988-01
NY
Other
Enumeration date
03/07/2024
Last updated
03/07/2024
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