Individual
JONATHAN DILLERA NIETES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSN, AGPC NP
Contact information
Practice address
425 W 59TH ST STE 4F, NEW YORK, NY 10019-8022
(212) 241-1272
Mailing address
425 W 59TH ST STE 4F, NEW YORK, NY 10019-8022
(917) 982-6498
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F309611
NY
Other
Enumeration date
11/05/2020
Last updated
02/10/2023
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