Individual
YELISA JIMENEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(917) 407-3388
Mailing address
69 BANK ST, VALLEY STREAM, NY 11580-1005
(917) 407-3388
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
309441
NY
Other
Enumeration date
11/03/2019
Last updated
08/01/2023
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