Individual
JOHANE N/A DESRUISSEAUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
81 JUNIUS ST, BROOKLYN, NY 11212-8004
(718) 866-1055
Mailing address
30 E 33RD ST, NEW YORK, NY 10016-5337
(212) 366-4459
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F405123-01
NY
Other
Enumeration date
01/31/2024
Last updated
09/11/2024
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