Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | F310337 | NY |
NPI | 1013677210 |
---|---|
Provider Name | Fabiola Plessy |
First Address | Bronx, NY 10461-2507 |
Second Address | Bronx, NY 10453-4303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2021 |
Last Update Date | 29/12/2021 |