Individual
CORALEEN ITABLE FOSELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1305 YORK AVE, 4TH FLOOR, NEW YORK, NY 10021-5663
(646) 962-5483
(646) 962-0363
Mailing address
525 E 68TH ST, BOX 308, NEW YORK, NY 10065-4870
(646) 962-5483
(646) 962-0363
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F301611
NY
Other
Enumeration date
01/25/2008
Last updated
01/25/2008
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