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Individual

MRS. MIOSOTY I DESUEZA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
416 PARK AVE, PATERSON, NJ 07504-1989
(973) 684-8138
Mailing address
110 ILLINOIS AVE, PATERSON, NJ 07503-1637
(973) 801-1143

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ14924700
NJ
363LP2300X
Primary Care Nurse Practitioner
Primary
26NJ14924700
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0961621
NJ
Enumeration date
10/23/2023
Last updated
03/18/2026
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